美国印第安人/阿拉斯加原住民男性接受初级保健提供者前列腺特异性抗原检测和直肠指检的可能性低于白人男性：2012-2018 年全国门诊医疗调查的二次分析。

American Indian/Alaska Native men are less likely to receive prostate-specific antigen testing and digital rectal exams from primary care providers than White men: a secondary analysis of the National Ambulatory Medical Care Survey from 2012-2018.

机构信息

Department of PA Studies, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA.

Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

出版信息

Cancer Causes Control. 2023 Sep;34(9):749-756. doi: 10.1007/s10552-023-01714-x. Epub 2023 May 23.

DOI:10.1007/s10552-023-01714-x

PMID:37217700

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10363029/

Abstract

PURPOSE

(1) Identify the proportion of primary care visits in which American Indian/Alaska Native (AI/AN) men receive a prostate-specific antigen test (PSAT)and/or a digital rectal exam (DRE), (2) describe characteristics of primary care visits in which AI/AN receive PSA and/or DRE, and (3) identify whether AI/AN receive PSA and/or DRE less often than non-Hispanic White (nHW) men.

METHODS

This was a secondary analysis of the National Ambulatory Medical Care Survey (NAMCS) during 2013-2016 and 2018 and the NAMCS Community Health Center (CHC) datasets from 2012-2015. Weighted bivariate and multivariable tests analyzed the data to account for the complex survey design.

RESULTS

For AI/AN men, 1.67 per 100 visits (95% CI = 0-4.24) included a PSATs (or PSAT) and 0 visits included a DRE between 2013-2016 and 2018. The rate of PSA for non-AI/AN men was 9.35 per 100 visits (95% CI = 7.78-10.91) and 2.52 per 100 visits (95% CI = 1.61-3.42) for DRE. AI/AN men were significantly less likely to receive a PSA than nHW men (aOR = 0.09, 95% CI = 0.01-0.83). In CHCs, AI/AN men experienced 4.26 PSAT per 100 visits (95% CI = 0.96-7.57) compared to 5.00 PSAT per 100 visits (95% CI = 4.40-5.68) for non-AI/AN men. DRE rates for AI/AN men was 0.63 per 100 visits (95% CI = 0-1.61) compared to 1.05 per 100 (95% CI = 0.74-1.37) for non-AI/AN men. There was not a statistically significant disparity in the CHC data regarding PSA (OR = 0.91, 95% CI = 0.42-1.98) or DRE (OR = 0.75, 95% CI = 0.15-3.74), compared to nHW men.

CONCLUSION

Efforts are needed to better understand why providers may not use PSA and DRE with AI/AN men compared to nHW men.

摘要

目的

（1）确定在初级保健就诊中，接受前列腺特异性抗原检测（PSAT）和/或直肠指检（DRE）的美国印第安人/阿拉斯加原住民（AI/AN）男性的比例，（2）描述 AI/AN 接受 PSA 和/或 DRE 检查的就诊特征，（3）确定 AI/AN 是否比非西班牙裔白人（nHW）男性接受 PSA 和/或 DRE 检查的频率更低。

方法

这是对 2013-2016 年和 2018 年国家门诊医疗调查（NAMCS）以及 2012-2015 年 NAMCS 社区卫生中心（CHC）数据集的二次分析。加权双变量和多变量检验用于分析数据，以考虑到复杂的调查设计。

结果

对于 AI/AN 男性，2013-2016 年和 2018 年期间，每 100 次就诊中，有 1.67 次（95%CI=0-4.24）包括 PSATs（或 PSAT），而无 DRE。非 AI/AN 男性的 PSA 率为每 100 次就诊 9.35 次（95%CI=7.78-10.91），DRE 率为每 100 次就诊 2.52 次（95%CI=1.61-3.42）。AI/AN 男性接受 PSA 检测的可能性明显低于 nHW 男性（比值比[OR] = 0.09，95%CI=0.01-0.83）。在 CHC 中，AI/AN 男性每 100 次就诊接受 4.26 次 PSAT（95%CI=0.96-7.57），而非 AI/AN 男性每 100 次就诊接受 5.00 次 PSAT（95%CI=4.40-5.68）。AI/AN 男性的 DRE 率为每 100 次就诊 0.63 次（95%CI=0-1.61），而非 AI/AN 男性为每 100 次就诊 1.05 次（95%CI=0.74-1.37）。与 nHW 男性相比，CHC 数据中 PSA（OR=0.91，95%CI=0.42-1.98）或 DRE（OR=0.75，95%CI=0.15-3.74）的差异没有统计学意义。