Association of black race with follow-up of an abnormal prostate-specific antigen test

Barbara J. Turner, Shahrzad Mavandadi, Mark G. Weiner

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Delayed evaluation after a clearly abnormal prostate-specific antigen (PSA) result may contribute to more advanced prostate cancer at diagnosis in black men. In 46 primary care practices over a period of 4.5 years, we studied men aged more than 50 years without known prostate cancer who had a PSA of at least 10.0 ng/mL for the first time. PSA follow-up included: a urology appointment, a new prostate diagnosis, or repeat PSA test. Cox proportional hazards models assessed time to follow-up, adjusting for demographic, clinical, and health care factors with censoring at a time that represents excessive delay (200 days). Among all 724 study men (27% black), delay until PSA follow-up averaged 115.2 days (± 79.7 d) and the unadjusted hazard ratio (HR) for follow-up was shorter for black men than nonblack men (HR, 1.23; 95% CI, 1.00-1.51). However, black men were more likely to have had prior urology care and had higher index PSA levels than other men; both factors were associated with shorter follow-up. After adjustment, delay did not differ for black vs nonblack race (HR, 1.05; 95% CI, 0.78-1.43) but men aged at least 75 years had a longer delay than men aged 74 years or less (HR, 0.72; 95% CI, 0.59-0.89). Despite black men having greater risk of advanced prostate disease at diagnosis and better linkage to urologic care, follow-up was delayed, on average, by more than 3 months and did not differ by race. These results reveal a potentially important, remediable factor to improve prostate cancer prevention and care for black men.

Original languageEnglish (US)
Pages (from-to)150-157
Number of pages8
JournalJournal of the National Medical Association
Volume103
Issue number2
StatePublished - Feb 2011

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Prostate-Specific Antigen
Prostatic Neoplasms
Urology
Prostate
Aftercare
Proportional Hazards Models
Primary Health Care
Appointments and Schedules
Demography
Delivery of Health Care

Keywords

  • African Americans
  • Physicians
  • Prostate cancer
  • Prostate-specific antigen

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Association of black race with follow-up of an abnormal prostate-specific antigen test. / Turner, Barbara J.; Mavandadi, Shahrzad; Weiner, Mark G.

In: Journal of the National Medical Association, Vol. 103, No. 2, 02.2011, p. 150-157.

Research output: Contribution to journalArticle

Turner, Barbara J. ; Mavandadi, Shahrzad ; Weiner, Mark G. / Association of black race with follow-up of an abnormal prostate-specific antigen test. In: Journal of the National Medical Association. 2011 ; Vol. 103, No. 2. pp. 150-157.
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