UP-4 Self-reported health literacy as a modifier for prostate cancer screening
Thursday June 27, 2019 from
Award Winner
Chase W Mallory, United States has been granted the

Chase W Mallory, United States

Medical Student


Florida International University Herbert Wertheim College of Medicine


Self-reported health literacy as a modifier for prostate cancer screening

Scott Jamieson1, Chase Mallory1, Dhaval Jivanji1, Alejandra Perez2, Grettel Castro1, Noel Barengo1,3,4, Jorge Pereira2, Alan Nieder2.

1Translational Research, Florida International University Herbert Wertheim College of Medicine, Miami, FL, United States; 2Division of Urology, Mt. Sinai Medical Center Columbia University, Miami Beach, FL, United States; 3Faculty of Medicine, Riga Stradins University, Riga, Latvia; 4Departmend of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland

Prostate cancer remains the most common cancer diagnosed in males. The prostate specific antigen test (PSA) is the most common screening tool for this cancer. Little scientific evidence is available regarding health literacy and its association with prostate cancer screening rates. We sought to determine whether an association exists. 

This retrospective cross-sectional study utilized 2016 Behavioral Risk Factor Surveillance System (BRFSS) data. Our primary exposure was self-reported health literacy and primary outcome was whether patients underwent PSA tests. Males 55-69 years old were included. Participants were excluded if they had missing data for the exposure or outcome. Health literacy was measured by aggregating scores of three survey questions assessing patients’ ability to gain access to health information, as well as understand written and verbal health information. Potential confounders included age, race, ethnicity, smoking history, body mass index (BMI), health insurance, education, exercise, income, alcohol use and marriage. Unadjusted and adjusted logistic regression analysis were used to calculate odds ratios (OR) and 95% confidence intervals (CI). 

Final analysis included 12,149 men, of which 5% reported low, 54% moderate, and 41% reported high health literacy levels. Compared with participants with high levels of health literacy, odds of a PSA test were 59% lower for men with low health literacy (OR 0.41; 95% CI 0.28, 0.64). The corresponding OR for those with moderate health literacy was 0.70 (95%CI 0.60, 0.83). Increased age, Black/African American race, Hispanic ethnicity, smoking history, elevated BMI, health insurance, high school education or greater, annual income over $50,000, and marriage were positively associated with PSA testing. 

Our research demonstrates a strong positive association between health literacy and the likelihood of PSA screening. Future studies examining how health literacy affects other urologic conditions are necessary. 

Lectures by Chase W Mallory

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