Regional and Racial Trends in US Prostate Cancer Screening

Objective: In this study, we examined whether self-reported prostate cancer screening rates differed by ethnicity. Methods: We used 2014 and 2018 data from the Behavioral Risk Factor Surveillance System (BRFSS) to determine if self-reported screening rates differed by ethnicity and year, while we controlled for geographic, demographic, and health factors. We also investigated factors that may influence screening rates. Results: Self-reported screening rates decreased between 2014 and 2018, both overall and by each ethnicity. Blacks had significantly higher odds of reporting a PSA test than Whites (OR = 1.13 ± 0.01 in 2014; 1.14 ± 0.01 in 2018); all other group had lower odds than Whites. By ethnicity, only Blacks and Native Hawaiians/Pacific Islanders had higher odds of being asked the questions than Whites; all other groups had lower odds. Overall screening rates were positively correlated with prostate cancer incidence rates by state but not for any racial group individually. Conclusions: Self-reported PSA test rates are declining, are associated with PSA test knowledge, are less likely in non-black minorities, and may be influenced by healthcare discussions and state-level incidence rates