The Relationship Between Education and Prostate-Specific Antigen Testing Among Urban African American Medicare Beneficiaries

Mohammad Khalid Hararah; Craig Evan Pollack; Mary A. Garza; Hsin Chieh Yeh; Diane Markakis; Darcy F. Phelan-Emrick; Jennifer Wenzel; Gary R. Shapiro; Lee Bone; Lawrence Johnson; Jean G. Ford

doi:10.1007/s40615-014-0061-z

The Relationship Between Education and Prostate-Specific Antigen Testing Among Urban African American Medicare Beneficiaries

Mohammad Khalid Hararah, Craig Evan Pollack, Mary A. Garza, Hsin Chieh Yeh, Diane Markakis, Darcy F. Phelan-Emrick, Jennifer Wenzel, Gary R. Shapiro, Lee Bone, Lawrence Johnson, Jean G. Ford

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

PURPOSE: We examined the association between socioeconomic status (SES) and prostate-specific antigen (PSA) cancer screening among older African American men.

METHODS: We analyzed baseline data from a sample of 485 community-dwelling African American men who participated in the Cancer Prevention and Treatment Demonstration Trial. The outcome was receipt of PSA screening within the past year. SES was measured using income and educational attainment. Sequential multivariate logistic regression models were performed to study whether health care access, patient-provider relationship, and cancer fatalism mediated the relationship between SES and PSA screening.

RESULTS: Higher educational attainment was significantly associated with higher odds of PSA screening in the past year (odds ratio (OR) 2.08 for college graduate compared to less than high school graduate, 95 % confidence interval (CI) 1.03-4.24); income was not. Health care access and patient-provider communication did not alter the relationship between education and screening; however, beliefs regarding cancer fatalism partially mediated the observed relationship.

CONCLUSION: Rates of prostate cancer screening among African American men vary by level of educational attainment; beliefs concerning cancer fatalism help explain this gradient. Understanding the determinants of cancer fatalism is a critical next step in building interventions that seek to ensure equitable access to prostate cancer screening.

Original language	English (US)
Pages (from-to)	176-183
Number of pages	8
Journal	Journal of Racial and Ethnic Health Disparities
Volume	2
Issue number	2
DOIs	https://doi.org/10.1007/s40615-014-0061-z
State	Published - Jun 1 2015

Keywords

Cancer screening: African American
Education
Prostate cancer
Prostate-specific antigen
Socioeconomic status

ASJC Scopus subject areas

Health(social science)
Anthropology
Sociology and Political Science
Health Policy
Public Health, Environmental and Occupational Health

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10.1007/s40615-014-0061-z

Cite this

Hararah, M. K., Pollack, C. E., Garza, M. A., Yeh, H. C., Markakis, D., Phelan-Emrick, D. F., Wenzel, J., Shapiro, G. R., Bone, L., Johnson, L., & Ford, J. G. (2015). The Relationship Between Education and Prostate-Specific Antigen Testing Among Urban African American Medicare Beneficiaries. Journal of Racial and Ethnic Health Disparities, 2(2), 176-183. https://doi.org/10.1007/s40615-014-0061-z

Hararah, MK, Pollack, CE, Garza, MA, Yeh, HC, Markakis, D, Phelan-Emrick, DF , Wenzel, J, Shapiro, GR, Bone, L, Johnson, L & Ford, JG 2015, 'The Relationship Between Education and Prostate-Specific Antigen Testing Among Urban African American Medicare Beneficiaries', Journal of Racial and Ethnic Health Disparities, vol. 2, no. 2, pp. 176-183. https://doi.org/10.1007/s40615-014-0061-z

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title = "The Relationship Between Education and Prostate-Specific Antigen Testing Among Urban African American Medicare Beneficiaries",

abstract = "PURPOSE: We examined the association between socioeconomic status (SES) and prostate-specific antigen (PSA) cancer screening among older African American men.METHODS: We analyzed baseline data from a sample of 485 community-dwelling African American men who participated in the Cancer Prevention and Treatment Demonstration Trial. The outcome was receipt of PSA screening within the past year. SES was measured using income and educational attainment. Sequential multivariate logistic regression models were performed to study whether health care access, patient-provider relationship, and cancer fatalism mediated the relationship between SES and PSA screening.RESULTS: Higher educational attainment was significantly associated with higher odds of PSA screening in the past year (odds ratio (OR) 2.08 for college graduate compared to less than high school graduate, 95 % confidence interval (CI) 1.03-4.24); income was not. Health care access and patient-provider communication did not alter the relationship between education and screening; however, beliefs regarding cancer fatalism partially mediated the observed relationship.CONCLUSION: Rates of prostate cancer screening among African American men vary by level of educational attainment; beliefs concerning cancer fatalism help explain this gradient. Understanding the determinants of cancer fatalism is a critical next step in building interventions that seek to ensure equitable access to prostate cancer screening.",

keywords = "Cancer screening: African American, Education, Prostate cancer, Prostate-specific antigen, Socioeconomic status",

author = "Hararah, {Mohammad Khalid} and Pollack, {Craig Evan} and Garza, {Mary A.} and Yeh, {Hsin Chieh} and Diane Markakis and Phelan-Emrick, {Darcy F.} and Jennifer Wenzel and Shapiro, {Gary R.} and Lee Bone and Lawrence Johnson and Ford, {Jean G.}",

note = "Funding Information: This study was supported by Centers for Medicare and Medicaid Services (Grant #1A0CMS300066 and U54CA153710). Additionally, Dr. Mary A. Garza was supported, in part, through her Mentored Research Scientist Development Award to Promote Diversity (K01CA140358). Dr. Pollack{\textquoteright}s salary is supported by the National Cancer Institute (NCI) and Office of Behavioral and Social Sciences (K07 CA151910). Dr. Wenzel was supported, in part, by her American Cancer Society Mentored Research Scholar Grant (117902-MRSGT-09-152-01-CPPB). Funding Information: This analysis is based on data from the baseline interview of 485 Baltimore City, community-dwelling African American men, age 65–75 years participating in the Cancer Prevention and Treatment Demonstration Project (CPTD). CPTD was funded by the Centers for Medicare & Medicaid Services (CMS) between April 2006 and December 2010. The Johns Hopkins University Institutional Review Board approved the study. ",

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T1 - The Relationship Between Education and Prostate-Specific Antigen Testing Among Urban African American Medicare Beneficiaries

AU - Hararah, Mohammad Khalid

AU - Pollack, Craig Evan

AU - Garza, Mary A.

AU - Yeh, Hsin Chieh

AU - Markakis, Diane

AU - Phelan-Emrick, Darcy F.

AU - Wenzel, Jennifer

AU - Shapiro, Gary R.

AU - Bone, Lee

AU - Johnson, Lawrence

AU - Ford, Jean G.

N1 - Funding Information: This study was supported by Centers for Medicare and Medicaid Services (Grant #1A0CMS300066 and U54CA153710). Additionally, Dr. Mary A. Garza was supported, in part, through her Mentored Research Scientist Development Award to Promote Diversity (K01CA140358). Dr. Pollack’s salary is supported by the National Cancer Institute (NCI) and Office of Behavioral and Social Sciences (K07 CA151910). Dr. Wenzel was supported, in part, by her American Cancer Society Mentored Research Scholar Grant (117902-MRSGT-09-152-01-CPPB). Funding Information: This analysis is based on data from the baseline interview of 485 Baltimore City, community-dwelling African American men, age 65–75 years participating in the Cancer Prevention and Treatment Demonstration Project (CPTD). CPTD was funded by the Centers for Medicare & Medicaid Services (CMS) between April 2006 and December 2010. The Johns Hopkins University Institutional Review Board approved the study.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - PURPOSE: We examined the association between socioeconomic status (SES) and prostate-specific antigen (PSA) cancer screening among older African American men.METHODS: We analyzed baseline data from a sample of 485 community-dwelling African American men who participated in the Cancer Prevention and Treatment Demonstration Trial. The outcome was receipt of PSA screening within the past year. SES was measured using income and educational attainment. Sequential multivariate logistic regression models were performed to study whether health care access, patient-provider relationship, and cancer fatalism mediated the relationship between SES and PSA screening.RESULTS: Higher educational attainment was significantly associated with higher odds of PSA screening in the past year (odds ratio (OR) 2.08 for college graduate compared to less than high school graduate, 95 % confidence interval (CI) 1.03-4.24); income was not. Health care access and patient-provider communication did not alter the relationship between education and screening; however, beliefs regarding cancer fatalism partially mediated the observed relationship.CONCLUSION: Rates of prostate cancer screening among African American men vary by level of educational attainment; beliefs concerning cancer fatalism help explain this gradient. Understanding the determinants of cancer fatalism is a critical next step in building interventions that seek to ensure equitable access to prostate cancer screening.

AB - PURPOSE: We examined the association between socioeconomic status (SES) and prostate-specific antigen (PSA) cancer screening among older African American men.METHODS: We analyzed baseline data from a sample of 485 community-dwelling African American men who participated in the Cancer Prevention and Treatment Demonstration Trial. The outcome was receipt of PSA screening within the past year. SES was measured using income and educational attainment. Sequential multivariate logistic regression models were performed to study whether health care access, patient-provider relationship, and cancer fatalism mediated the relationship between SES and PSA screening.RESULTS: Higher educational attainment was significantly associated with higher odds of PSA screening in the past year (odds ratio (OR) 2.08 for college graduate compared to less than high school graduate, 95 % confidence interval (CI) 1.03-4.24); income was not. Health care access and patient-provider communication did not alter the relationship between education and screening; however, beliefs regarding cancer fatalism partially mediated the observed relationship.CONCLUSION: Rates of prostate cancer screening among African American men vary by level of educational attainment; beliefs concerning cancer fatalism help explain this gradient. Understanding the determinants of cancer fatalism is a critical next step in building interventions that seek to ensure equitable access to prostate cancer screening.

KW - Cancer screening: African American

KW - Education

KW - Prostate cancer

KW - Prostate-specific antigen

KW - Socioeconomic status

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The Relationship Between Education and Prostate-Specific Antigen Testing Among Urban African American Medicare Beneficiaries

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