Prostate-specific Antigen Testing in Men with Disabilities: A Cross-sectional Analysis of the Health Information National Trends Survey

Abstract

Background: Patients with disabilities represent a unique minority population. The incidence of prostate-specific antigen (PSA) testing among this population is unknown.

Objective: To compare PSA testing rates and associated predictors among men with and without reported disabilities in the USA.

Design, setting, and participants: A cross-sectional study of the Health Information National Trends Survey (HINTS) for the years 2012, 2013, 2017 and 2019 was conducted in men with reported disabilities.

Outcome measurements and statistical analysis: Baseline demographics of the entire cohort were stratified based on their reported disabilities (none, disabled, deaf, and blind). Each disability was compared separately and in combination with the cohort without disabilities. Multivariable logistic regression models determined clinically significant predictors of PSA testing in men with disabilities compared with those without.

Results and limitations: Overall, 782 (15%) men with disabilities were compared with 4569 (85%) men without disabilities. The former cohort was older with a median (interquartile range) age of 65 (56-75) versus 57 (43-67) yr (p < 0.001). On multivariable analysis, men with any disability were less likely to undergo PSA testing (odds ratio 0.77, 95% confidence interval 0.62-0.96, p = 0.018). Variables associated with increased PSA testing included age, having a health care provider, health insurance, and living with a partner.

Conclusions: Inequalities in PSA testing exist among men with disabilities in the USA, especially among the deaf and blind, being less likely to undergo PSA testing. Further research is required to identify and deal with any obstacles in the implementation of equal PSA testing in this unique population.

Patient summary: In the USA, men with reported disabilities are less likely to undergo PSA testing than patients without reported disabilities.

Keywords: Detection; Disability; Prostate cancer; Prostate-specific antigen; Screening; Testing.