The Role of Health Literacy in Prostate Cancer Screening - 28/05/22

Doi : 10.1016/j.urology.2021.05.100

Scott C. Jamieson ^1,^{^{#
Authors contributed to this work equally.},}^⁎ , Chase W. Mallory ¹, Dhaval R. Jivanji ¹, Alejandra Perez ², Grettel Castro ¹, Noël C. Barengo ^1,^3,⁴, Jorge Pereira ², Alan M. Nieder ²
¹ Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
² Division of Urology, Mount Sinai Medical Center, Columbia University, FL
³ Faculty of Medicine, Riga Stradins University, Riga, Latvia
⁴ Department of Public Health, University of Helsinki, Finland

^⁎Address correspondence to: Scott C. Jamieson, BA, Department of Translational Medicine, Florida International University, Herbert Wertheim College of Medicine, 11200 SW 8th street, Miami, FL 33199.Department of Translational MedicineFlorida International University, Herbert Wertheim College of Medicine11200 SW 8th streetMiamiFL33199

Abstract

Objective

To determine if there is an association between self-reported health literacy and rates of prostate cancer screening through PSA testing.

Methods

This secondary data analysis utilized information from the 2016 Behavioral Risk Factor Surveillance System (BRFSS). The primary exposure was self-reported health literacy, and the primary outcome was whether patients underwent prior PSA testing. Males 55-69 years old from 13 states were included in the study and were excluded if they had any missing data. Participants were categorized into low, moderate, or high level of health literacy. Confounders were adjusted for using binary logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were calculated.

Results

A total of 12,149 participants were included. Five percent of participants reported low health literacy, 54% moderate health literacy, and 41% high health literacy. Compared with study participants who self-reported high levels of health literacy, the odds of undergoing PSA testing were 59% lower in those with low health literacy (OR 0.41; 95% CI 0.28-0.64) and 30% lower in those with moderate health literacy (OR 0.70; 95% CI 0.60-0.83).

Conclusions

Our research demonstrates a positive association between self-reported health literacy and the likelihood of PSA screening. While PSA screening can be controversial, health literacy may serve as a window into which patients are more likely to be proactive in their urologic care. Future studies examining how health literacy effects other urologic conditions is necessary.

Le texte complet de cet article est disponible en PDF.