Males with disabilities had been considerably much less more likely to have undergone prostate-specific antigen (PSA) testing than males with out disabilities, in line with outcomes from a cross-sectional research of the 2023 Behavioral Danger Issue Surveillance System (BRFSS) printed in JAMA Community Open.
Amongst a weighted pattern of 5,058,866 US males aged 55 to 69 years, 62.7% (95% CI, 61.1%-64.3%) reported a historical past of PSA testing. Screening charges had been decrease amongst males with any incapacity than amongst these with out (57.2% [95% CI, 54.2%-60.2%] vs 65.1% [95% CI, 63.2%-67.0%]; P <.001). After adjustment for sociodemographic elements, insurance coverage standing, comorbidities, and well being behaviors, incapacity remained related to decrease odds of PSA testing (adjusted odds ratio [aOR], 0.83; 95% CI, 0.69-0.99; P = .046).
Amongst particular incapacity sorts, solely mobility incapacity remained considerably related to decrease screening in adjusted fashions (aOR, 0.77; 95% CI, 0.62-0.96; P = .02). Cognitive (aOR, 0.86; 95% CI, 0.67-1.10; P = .23), imaginative and prescient (aOR, 0.94; 95% CI, 0.67-1.33; P = .76), listening to (aOR, 0.99; 95% CI, 0.79-1.25; P = .94), and self-care (aOR, 0.77; 95% CI, 0.56-1.06; P = .11) disabilities had been all related to level estimates under 1 however didn’t attain statistical significance. In an unweighted sensitivity evaluation, the affiliation between any incapacity and decrease PSA testing remained important (OR, 0.86; 95% CI, 0.77-0.98; P = .02), according to the first weighted estimate.
“Physicians ought to keep away from assuming that sufferers with disabilities could not profit from screening,” lead writer José I. Nolazco, MD, MMSc, a Harvard Medical College Urologic Oncology fellow of the division of Urology at Mass Basic Brigham and Harvard Medical College, and coauthors wrote within the publication. “As a substitute, they need to explicitly focus on the potential advantages and harms of screening throughout the context of every affected person’s total well being standing, life expectancy, and private priorities.”
The evaluation included 10,508 male BRFSS respondents aged 55 to 69 years with full PSA testing and incapacity information, according to US Preventive Companies Job Drive screening-age suggestions. The imply weighted age amongst these with disabilities was 62.2 years (SD, 4), of whom 68.2% had been White and 49.2% had been overweight.
Incapacity standing was assessed utilizing the usual 6-question sequence, a validated measure capturing mobility, cognitive, listening to, imaginative and prescient, self-care, and impartial residing limitations. Total, a weighted 29.6% (95% CI, 28.1%-31.1%) of members reported not less than 1 incapacity, mostly mobility limitations (17.4%; 95% CI, 16.1%-18.6%). Survey-weighted logistic regression fashions estimated crude and adjusted ORs, with a number of imputation used for lacking covariate information.
The first end result was self-reported PSA testing historical past. Secondary analyses assessed variations in screening charges throughout the 6 particular person incapacity sorts.
The authors famous a number of limitations, together with the cross-sectional design, which precludes causal inference, and the self-reported nature of PSA testing and incapacity standing, which can introduce recall bias. The BRFSS additionally lacks life-expectancy information, limiting the flexibility to find out what portion of decrease screening displays applicable medical omission, and excludes institutionalized people, doubtlessly underestimating disparities amongst these with extra extreme disabilities.
The findings are according to a previous nationwide survey evaluation that discovered males with any self-reported incapacity had roughly 23% decrease odds of PSA screening.2 The authors pointed to doctor bias as one potential contributing issue, citing a 2021 survey wherein 59.3% of physicians reported missing confidence in offering equal care to sufferers with disabilities, with 82.4% agreeing with the premise that sufferers with important disabilities expertise suboptimal quality-of-life outcomes.3
Reference
- Nolazco JI, Iezzoni LI, Chen EC, et al. Incapacity standing and prostate most cancers screening amongst US males aged 55 to 69 years. JAMA Netw Open. 2026;9(8):e2627708. doi:10.1001/jamanetworkopen.2026.27708
- Leong JY, Pinkhasov R, Chandrasekar T, et al. Prostate-specific antigen testing in males with disabilities: a cross-sectional evaluation of the Well being Data Nationwide Tendencies Survey. Eur Urol Focus. 2022;8(5):1125-1132. doi:10.1016/j.euf.2021.07.009
- Iezzoni LI, Rao SR, Ressalam J, et al. Physicians’ perceptions of individuals with incapacity and their well being care. Well being Aff (Millwood). 2021;40(2):297-306. doi:10.1377/hlthaff.2020.01452
