Prostate Cancer Screening Among American Indians and Alaska Natives: The Health and Retirement Survey, 1996-2008

Prev Chronic Dis. 2015 Aug 6:12:E123. doi: 10.5888/pcd12.150088.

Abstract

Introduction: Among US men, prostate cancer is the leading malignancy diagnosed and the second leading cause of cancer death. Disparities in cancer screening rates exist between American Indians/Alaska Natives and other racial/ethnic groups. Our study objectives were to examine prostate screening at 5 time points over a 12-year period among American Indian/Alaska Native men aged 50 to 75 years, and to compare their screening rates to African American men and white men in the same age group.

Methods: We analyzed Health and Retirement Study data for 1996, 1998, 2000, 2004, and 2008. Prostate screening was measured by self-report of receipt of a prostate examination within the previous 2 years. Age-adjusted prevalence was estimated for each year. We used regression with generalized estimating equations to compare prostate screening prevalence by year and race.

Results: Our analytic sample included 119 American Indian/Alaska Native men (n = 333 observations), 1,359 African American men (n = 3,704 observations), and 8,226 white men (n = 24,292 observations). From 1996 to 2008, prostate screening rates changed for each group: from 57.0% to 55.7% among American Indians/Alaska Natives, from 62.0% to 71.2% among African Americans, and from 68.6% to 71.3% among whites. Although the disparity between whites and African Americans shrank over time, it was virtually unchanged between whites and American Indians/Alaska Natives.

Conclusion: As of 2008, American Indians/Alaska Natives were less likely than African Americans and whites to report a prostate examination within the previous 2 years. Prevalence trends indicated a modest increase in prostate cancer screening among African Americans and whites, while rates remained substantially lower for American Indians/Alaska Natives.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Alaska / ethnology
  • Analysis of Variance
  • Black or African American / statistics & numerical data
  • Health Behavior / ethnology*
  • Health Surveys
  • Healthcare Disparities / ethnology
  • Humans
  • Indians, North American / statistics & numerical data*
  • Male
  • Mass Screening / trends*
  • Middle Aged
  • Prevalence
  • Prostatic Neoplasms / diagnosis*
  • Regression Analysis
  • Retirement*
  • Self Report
  • Surveys and Questionnaires
  • United States / epidemiology
  • White People / statistics & numerical data