Date of Conferral
8-5-2024
Date of Award
August 2024
Degree
Ph.D.
School
Public Health
Advisor
Lee Caplan
Abstract
In 2012, the U.S. Preventive Services Task Force revised its prostate cancer screening recommendations to advocate against the routine use of prostate-specific antigen-based testing. This cross-sectional study of a large dataset from the Surveillance, Epidemiology, and End Results Program compared PSA-based diagnoses made from 2006 to 2011 to those from 2013 to 2018. The study aimed to address the impact of the change in recommendation on survival and stage at diagnosis in prostate cancer patients. The socioecological model was used as the theoretical foundation for the study. A total of 205,129 men diagnosed with prostate cancer comprised the study population. The study found a difference in the survival distributions of the two groups, with higher survival for men diagnosed before 2012 (��2(1) = 81.662, p < 0.001). Cox regression showed a statistically significant 12.6% higher risk of death in those diagnosed after 2012 (HR = 1.126; 95% CI = 1.104, 1.148; p < 0.001), controlling for race and age. Regarding the stage at diagnosis, there was a statistically significant difference in the probability of being diagnosed with advanced stage (regional or distant) cancer (��2(1) = 1283.524, p < 0.001) between the two groups, with higher probability in those diagnosed after 2012. Logistic regression demonstrated higher odds of being diagnosed with advanced-stage cancer in those diagnosed after 2012, controlling for race and age (OR=1.530; 95% CI = 1.496, 1.564; p < 0.001). These study findings could lead to positive social change by contributing to more effective prostate cancer screening practices, potentially reducing the high mortality linked to late prostate cancer diagnosis.
Recommended Citation
Dennis, treves M., "Prostate Specific Antigen-Based Cancer Screening in the United States" (2024). Walden Dissertations and Doctoral Studies. 16266.
https://scholarworks.waldenu.edu/dissertations/16266
