Echeverri Margarita, Felder Kyazia, Anderson David, Apantaku Elora
Division of Clinical and Administrative Sciences, College of Pharmacy, Xavier University of Louisiana, New Orleans, LA 70125, USA.
Department of Mathematics, College of Arts and Science, Xavier University of Louisiana, New Orleans, LA 70125, USA.
J Mens Health. 2025 Jan;21(1):39-50. Epub 2025 Jan 30.
African American men (AAM) have persistently had the highest incidence and mortality rates for prostate cancer (PrCa) in the United States. Considering that current guidelines recommend the practice of shared decision-making to determine whether or not to undergo a Prostate-Specific Antigen (PSA) test for the early detection of PrCa, this study focuses on the identification of key factors influencing AAM decisions regarding having or not having PSA screenings.
Cross-sectional study of 152 AAM who completed study surveys. Statistical analysis included frequencies, means, and distributions and methods to test for differences in knowledge confidence, satisfaction and, self-efficacy when making decisions.
94% of participants would get a PSA test if offered, only 57% knew that the PSA test is a blood test. Participants who reported having had a PSA test before the baseline had significantly higher mean scores than their counterparts in the knowledge about the definition of the PSA and biopsy exams ( = 0.04), and in the confidence ( = 0.005) and efficacy ( = 0.002) scales when making PSA screening decisions. Older participants were more likely to have had a PSA test ( < 0.0001) and to intend to screen ( = 0.0441).
Significant differences in the satisfaction scale by clinical site ( < 0.001) may underscore the influence of clinicians' practices in participants' satisfaction with their decisions. Results suggest that patients' experience of care has the potential to positively influence PSA screening. It is our call that type of health insurance, knowledge about PrCa and PSA, and having had a PSA test in the past, as well as the patient's characteristics (age, race and family history of PrCa) be considered when discussing with patients the harms/benefits of PSA screening and their preferences to have or not have the PSA test.
在美国，非裔美国男性（AAM）的前列腺癌（PrCa）发病率和死亡率一直居高不下。鉴于当前指南建议采用共同决策的方式来决定是否进行前列腺特异性抗原（PSA）检测以早期发现PrCa，本研究着重于确定影响AAM进行或不进行PSA筛查决策的关键因素。
对152名完成研究调查的AAM进行横断面研究。统计分析包括频率、均值、分布以及用于检验决策时知识信心、满意度和自我效能差异的方法。
94%的参与者表示若有机会会接受PSA检测，只有57%的人知道PSA检测是一项血液检测。在基线之前报告曾进行过PSA检测的参与者，在PSA定义和活检检查知识方面的平均得分显著高于未进行过检测的参与者（P = 0.04），在进行PSA筛查决策时的信心量表（P = 0.005）和效能量表（P = 0.002）得分也更高。年龄较大的参与者更有可能进行过PSA检测（P < 0.0001）且更倾向于进行筛查（P = 0.0441）。
临床机构在满意度量表上存在显著差异（P < 0.001），这可能凸显了临床医生的诊疗行为对参与者决策满意度的影响。结果表明，患者的就医体验有可能对PSA筛查产生积极影响。我们认为，在与患者讨论PSA筛查的利弊以及他们进行或不进行PSA检测的偏好时，应考虑健康保险类型、对PrCa和PSA的了解、过去是否进行过PSA检测以及患者特征（年龄、种族和PrCa家族史）。
