To evaluate how limited English proficiency (LEP) impacts the prevalence of prostate-specific antigen (PSA) screening in a contemporary, nationally representative cohort of men in the USA.
The Medical Expenditure Panel Survey was utilized to identify the prevalence of PSA screening between 2013 and 2016 among men ≥ 55. Men who speak a language other than English at home were stratified by self-reported levels of English proficiency (men who speak English very well, well, not well, or not at all). Survey weights were applied, and groups were compared using the adjusted Wald test. A multivariable logistic regression model was used to identify predictors of PSA screening adjusting for patient-level covariates.
The cohort included 2,889 men, corresponding to a weighted estimate of 4,765,682 men. 79.6% of men who speak English very well reported receiving at least one lifetime PSA test versus 58.4% of men who do not speak English at all (p < 0.001). Men who reported not speaking English at all had significantly lower prevalence of PSA screening (aOR 0.56; 95% CI 0.35-0.91; p = 0.019). Other significant predictors of PSA screening included older age, income > 400% of the federal poverty level, insurance coverage, and healthcare utilization.
Limited English proficiency is associated with significantly lower prevalence of PSA screening among men in the USA. Interventions to mitigate disparities in prostate cancer outcomes should account for limited English proficiency among the barriers to guideline-concordant care.
World journal of urology. 2024 Jan 20*** epublish ***
Benjamin V Stone, Muhieddine Labban, Edoardo Beatrici, Dejan K Filipas, Nicola Frego, Zhiyu Jason Qian, Sandeep S Voleti, Nora Y Osman, Mark M Pomerantz, Stuart R Lipsitz, Adam S Feldman, Adam S Kibel, Alexander P Cole, Quoc-Dien Trinh
Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St., Boston, MA, 02115, USA., Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA., Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA., Department of Urology, Massachusetts General Hospital, Boston, MA, USA., Division of Urological Surgery, Brigham and Women's Hospital, Boston, MA, USA., Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St., Boston, MA, 02115, USA. .