ArticleProstate cancer and prostatic diseases2013
Health disparities in clinical practice patterns for prostate cancer screening by geographic regions in the United States: a multilevel modeling analysis.
Article in Prostate cancer and prostatic diseases, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence.Frontiers in oncology · 2019Pooled it
- The prevalence and predictors of previous prostate cancer screening among men attending primary healthcare centers in Riyadh, Saudi Arabia.Annals of medicine · 2026Article
- Geographic and Temporal Patterns of Screening for Breast, Cervical, and Colorectal Cancer in the US, 1997-2019.JAMA network open · 2025Article
- Small Area Estimation of PSA Testing in US States and Counties.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Racial and Ethnic Variation in PSA Testing and Prostate Cancer Incidence Following the 2012 USPSTF Recommendation.Journal of the National Cancer Institute · 2021Article
- Association Between Antidiabetic Medications and Prostate-Specific Antigen Levels and Biopsy Results.JAMA network open · 2019Article
- Epidemiological Determinants of Advanced Prostate Cancer in Elderly Men in the United States.Clinical Medicine Insights. Oncology · 2019Article
- Trends in Prostate Cancer Incidence Rates and Prevalence of Prostate Specific Antigen Screening by Socioeconomic Status and Regions in the United States, 2004 to 2013.The Journal of urology · 2018Article
- Prostate cancer health disparities: An immuno-biological perspective.Cancer letters · 2018Article
- Circumcision and prostate cancer: a population-based case-control study in Montréal, Canada.BJU international · 2014Article
- A comparison of US and Australian men's values and preferences for PSA screening.BMC health services research · 2013Article
- Prostate examination among adult and elderly subjects in southern Brazil: a cross-sectional population-based study.Sao Paulo medical journal = Revista paulista de medicinaArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo our knowledge, no previous study has examined state-level geographic variability and its predictors in clinical practice patterns to screen for prostate cancer in the United States.
methodsWe used the Behavioral Risk Factor Surveillance System 2010 data set to analyze geographic variability (by state) and its associated predictors in receiving a PSA test and/or a digital rectal examination (DRE). The study population consisted of men aged ≥50 years who responded as yes/no when asked about having a PSA test or DRE performed during the last year. We build two multilevel logistic regression models, differing in dependent variables, that is, (1) any prostate cancer screening (PCS) (either PSA and/or DRE), and (2) PCS based on PSA testing (PSAT). Individual characteristics (age, education, employment, marriage, income, race/ethnicity, self-reported health status, obesity, alcohol consumption, smoking status, personal physician presence, and health insurance coverage) were treated as level-1 variables and state characteristics (number of doctors per 100 000 persons per state, US regions and metropolitan statistical area (MSA) codes) were treated as level-2 variables.
resultsWe found significant geographic variability in receiving PCS and PSAT screening in the United States. For PCS, MSA code was an independent predictor, with men living in urban areas having lower odds of screening (odds ratio (OR)=0.8, 95% confidence interval (CI)=0.7-0.9). In PSAT, the number of doctors per 100 000 persons per state was an independent predictor, with lowest quartile states (0-25% quartile) having lower odds of PSA-based screening (OR=0.78, 95% CI=063-0.94). In both models, all level-1 variables were independent predictors (P<0.05) of PCS, except self-reported health status.
conclusionsMen living in urban areas and states with lower prevalence of doctors have lower odds of screening for prostate cancer and PSAT, respectively, after adjusting for individual variables. Future studies should examine the reasons for these health disparities.
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