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共同决策时代非裔美国男性的医生咨询、前列腺癌知识与前列腺特异性抗原筛查

Physician Consultations, Prostate Cancer Knowledge, and PSA Screening of African American Men in the Era of Shared Decision-Making.

作者信息

Woods-Burnham Leanne, Stiel Laura, Wilson Colwick, Montgomery Susanne, Durán Alfonso M, Ruckle Herbert R, Thompson Rupert A, De León Marino, Casiano Carlos A

机构信息

1 Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA.

2 Loma Linda University School of Behavioral Health, Loma Linda, CA, USA.

出版信息

Am J Mens Health. 2018 Jul;12(4):751-759. doi: 10.1177/1557988318763673. Epub 2018 Apr 16.

DOI:10.1177/1557988318763673
PMID:29658371
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6131426/
Abstract

African American (AA)/Black men are more likely to develop aggressive prostate cancer (PCa), yet less likely to be screened despite guidelines espousing shared decision-making regarding PCa screening and prostate-specific antigen (PSA) testing. Given the documented racial disparities in PCa incidence and mortality, engaging interactions with physicians are especially important for AA/Black men. Thus, this study evaluated occurrence of physician-patient conversations among AA/Black men, and whether such conversations were associated with PCa knowledge. We also quantified the serum PSA values of participants who had, and had not, discussed testing with their physicians. Self-identified AA/Black men living in California and New York, ages 21-85, donated blood and completed a comprehensive sociodemographic and health survey ( n = 414). Less than half (45.2%) of participants had discussed PCa screening with their physicians. Multivariate analyses were used to assess whether physician-patient conversations predicted PCa knowledge after adjusting for key sociodemographic/economic and health-care variables. Increased PCa knowledge was correlated with younger age, higher income and education, and having discussed the pros and cons of PCa testing with a physician. Serum PSA values were measured by ELISA. Higher-than-normal PSA values were found in 38.5% of men who had discussed PCa screening with a physician and 29.1% who had not discussed PCa screening. Our results suggest that physician-AA/Black patient conversations regarding PCa risk need improvement. Encouraging more effective communication between physicians and AA/Black men concerning PCa screening and PSA testing has the potential to reduce PCa health disparities.

摘要

非裔美国(AA)/黑人男性更易患侵袭性前列腺癌(PCa),然而,尽管有指南支持就PCa筛查和前列腺特异性抗原(PSA)检测进行共同决策,但他们接受筛查的可能性却更低。鉴于PCa发病率和死亡率方面已记录的种族差异,与医生进行有效的互动对AA/黑人男性尤为重要。因此,本研究评估了AA/黑人男性中医患对话的发生率,以及此类对话是否与PCa知识相关。我们还对与医生讨论过检测和未讨论过检测的参与者的血清PSA值进行了量化。居住在加利福尼亚州和纽约州、年龄在21 - 85岁之间、自我认定为AA/黑人的男性献血并完成了一项全面的社会人口统计学和健康调查(n = 414)。不到一半(45.2%)的参与者与他们的医生讨论过PCa筛查。在调整关键社会人口统计学/经济和医疗保健变量后,使用多变量分析来评估医患对话是否能预测PCa知识。PCa知识的增加与年龄较小、收入和教育程度较高以及与医生讨论过PCa检测的利弊相关。通过酶联免疫吸附测定(ELISA)测量血清PSA值。在与医生讨论过PCa筛查的男性中,38.5%的人PSA值高于正常水平,在未讨论过PCa筛查的男性中,这一比例为29.1%。我们的结果表明,医生与AA/黑人患者关于PCa风险的对话需要改进。鼓励医生与AA/黑人男性就PCa筛查和PSA检测进行更有效的沟通有可能减少PCa健康差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/131f/6131426/b351af7d5a8a/10.1177_1557988318763673-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/131f/6131426/90be598f3abc/10.1177_1557988318763673-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/131f/6131426/b351af7d5a8a/10.1177_1557988318763673-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/131f/6131426/90be598f3abc/10.1177_1557988318763673-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/131f/6131426/b351af7d5a8a/10.1177_1557988318763673-fig2.jpg

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