Abstract PO-250: Factors associated with different levels of shared decision-making for prostate specific-antigen tests: Results from the National Health Interview Survey
Authors: Johnson Jarrett A. , Moser Richard P. , Ellison Gary L. , Martin Damali M. 
Published: December 2020

Background: Shared decision-making (SDM) discussions are recommended by professional organizations prior to all prostate specific-antigen (PSA) tests. During these discussions, clinicians are encouraged to disclose the advantages, disadvantages, and fidelity of the PSA test, thus arming the patient with the pertinent information to make an informed decision. However, research suggests that discussions about the use of PSA testing are rare. With a growing foreign-born population in the U.S. and the paucity of studies examining SDM, little is known about the demographic associations of SDM for U.S.-born and foreign-born men. Objectives: Our objectives were to examine the levels of SDM for PSA testing and associated factors among a population of U.S. and foreign-born men using data from a nationally representative, cross-sectional survey. Methods: Data were combined from the 2010 and 2015 National Health Interview Survey (NHIS). Eligibility included men ≥ 40 years old. Men were excluded if they indicated that they did not know if they ever had a PSA test, the test was not for a routine exam, or had missing information on socio-demographic variables of interest. SDM was operationalized into three mutually exclusive categories: full (all elements), partial (mixture of advantages and disadvantages with experts disagree), and none. Bivariate and multinomial logistic regression were used to examine levels of SDM and the associated socio-demographic factors. All analyses were completed using SAS version 9.4, were weighted and deemed statistically significant at α ≤ 0.05. Results: The analytic sample contained 6509 men, of which most were non- Hispanic whites (81.2%), 60-69 years (34.0)%, U.S.-born (90.5%); the receipt of full SDM was low (14.5%). The final multinomial logistic regression model included survey year, race/ethnicity, region, education, marital status, and type of insurance. Compared to men who received no SDM, full SDM was more likely for men surveyed in 2015 (Odds Ratio [OR]=1.59, 95% Confidence Interval [CI] [1.31 – 1.92]), non- Hispanic blacks compared to non-Hispanic whites (OR=1.69, 95% CI [1.29 – 2.22), college/technical school graduates compared to less than high school education (OR=1.95; 95% CI [1.40 – 2.71]), and those with dual eligible compare to men with private insurance (OR=2.91; 95% CI [1.40 – 2.71]). Similar results were observed for the receipt of partial SDM for non-Hispanic blacks compared to non-Hispanic whites (OR=1.43; 95% CI [1.18 – 1.73]), college/technical school graduates compared to less than high school education (OR=1.38; 95% CI [1.13 – 1.70]), and those with dual eligible compared to men with private insurance (OR=1.36; 95% CI [1.04 – 1.78]). Conclusion: Among U.S. and foreign-born men, the receipt of full SDM for PSA testing was low in the population and varied by year and socio-demographic factors, but not by nativity. Further studies are required to examine the reasons for the observed low rate of full SDM in this population.

Citation Format: Jarrett A. Johnson, Richard P. Moser, Gary L. Ellison, Damali M. Martin. Factors associated with different levels of shared decision-making for prostate specific-antigen tests: Results from the National Health Interview Survey [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-250.