Benjamin V. Stone, MD, fellow, urologic oncology, Massachusetts General Hospital, Brigham & Women’s Hospital, discusses clinical implications derived from a retrospective study on the effect of limited English proficiency on prostate-specific antigen (PSA) screening rates in American men with prostate cancer, as well as the need to improve equitable access to PSA screening across academic, and community centers.

In a retrospective study presented at the 2023 American Urological Association Annual Meeting, investigators collected data on PSA screening rates in patients who do not speak English as a first language. Patients were 55 years of age or older, and were stratified according to their level of English proficiency. Results showed that limited English proficiency was correlated with significantly lower rates of PSA screening, as patients who did not speak English well were less likely to undergo screening.

Although there are factors known to significantly influence screening behaviors, these results indicate that limited English proficiency may be a key driver of disparities in prostate cancer outcomes, Stone begins. Language barriers can prevent patients and practitioners from discussing the benefits and risks of PSA screening, limiting or preventing shared decision making, Stone explains. Additionally, limited English proficiency is associated with a higher incidence of advanced cancers at diagnosis, Stone adds.

Accordingly, efforts to address this disparity should implement strategies that focus on improving these patients' ability to navigate and access care, Stone states. For example, this could include the employment of cultural competency translators to ensure patients can make a fully informed decision, he says. Additionally, federal legislation has been enacted that mandates meaningful access to care for this patient population, Stone says. Overall, it is vital that adequate translator services be implemented across both major academic centers and in community settings, Stone emphasizes. This will allow patients to receive more equitable access to PSA screening regardless of location, Stone concludes. 

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Benjamin V. Stone, MD, discusses clinical implications derived from a retrospective study on the effect of limited English proficiency on prostate-specific antigen screening rates in American men with prostate cancer, as well as the need to improve equitable access to PSA screening across academic and community centers.


Dr Stone on the Investigation of Limited English Proficiency and PSA Screening Rates in Prostate Cancer

Benjamin V. Stone, MD, fellow, urologic oncology, Massachusetts General Hospital, Brigham & Women’s Hospital, discusses the association between language barriers and prostate-specific antigen (PSA) screening rates in American men.

In a retrospective study presented at the 2023 American Urological Association Annual Meeting, Stone and colleagues utilized the Medical Expenditure Panel Survey and identified men at least 55 years of age who do not speak English as a first language. Patients were stratified based on English proficiency (those who speak English very well vs well vs not well vs not at all).

Investigators collected data on whether these men had ever completed a PSA test, how long it had been since their last PSA test, and other socio-demographic and clinical baseline factors, Stone notes. The primary focus was on men who had reported never receiving a PSA test and how this related to their level of English proficiency, Stone explains.

Men who do not speak English were found to have a significantly lower rate of PSA screening, Stone continues. Findings showed that 79.6% of men who speak English very well reported receiving at least 1 lifetime PSA test; 58.4% of men who do not speak English at all received at least 1 PSA test. This pointed to a clear disparity in terms of access and knowledge of screening, Stone says.

Findings also showed that men who did not speak English well were significantly less likely to be screened, Stone continues. Investigators adjusted parameters for other factors, but men who did speak English were significantly less likely to be screened, Stone concludes.

Benjamin V. Stone, MD, discusses the association between language barriers and prostate-specific antigen screening rates in American men.


Benjamin V. Stone, MD

Articles

Dr Stone on the Investigation of Limited English Proficiency and PSA Screening Rates in Prostate Cancer

Dr Stone on the Association of Language Barriers and PSA Screening for Prostate Cancer