Analysis of Prostate Cancer Prevention Behavior in Florida Utilizing The 2002 BRFSS Data Yussif Dokurugu MPH Candidate April 9, 2004

Outline  Background  Purpose  Objectives  Methodology  Results  Conclusion  Limitations  Recommendations  Acknowledgement  Questions

Background & Epidemiological Relevance  Prostate cancer is a malignant tumor of the prostate gland, a walnut-sized organ located in front of the rectum and right below the bladder

Background & Epidemiological Relevance  Prostate Cancer (PC) is the single most common form of tumor  One new case of PC every three minutes  Is present in more than 9 million men

Background & Epidemiological Relevance  Kills one man every 13 minutes  Lacks national awareness  2003, 15,800 new PC cases in FL –2,100 cancer deaths in FL

Background & Epidemiological Relevance  Prostate Cancer develops in four stages: –Initiation –Promotion –Progression –Metastasis

Background & Epidemiological Relevance  Symptoms –Frequent urination –Burning with urination –Painful ejaculation –Blood in urine –Stiffness in lower back and hips

Background & Epidemiological Relevance  Risk Factors –Age –Race –Family history –Diet

Background & Epidemiological Relevance  Treatment options –Watchful waiting –Surgery –Radiation –Chemotherapy –Hormonal therapy  Treatment depends on –Confinement of cancer –Stage of cancer –Metastasis of cancer

Purpose To examine the preventive health practices and risk factors among men in Florida that are associated with the incidence of prostate cancer as reported in the Florida BRFSS data.

Objectives  To investigate demographic factors associated with the prostate cancer prevention behaviors  To examine the impact of health insurance and health utilization associated prostate cancer prevention behaviors

Methodology BRFSS  State-based  Cross-sectional  Non-institutionalized  Adult population over the age of 18  Developed and supported  Centers for Disease Control and Prevention (CDC)

Methodology  2002 BRFSS –Utilized state specific data  Statistical Analysis System (SAS) 9.0  Univariate (Frequencies)  Bivariate comparisons  Multivariate Analysis –Logistic Regression analysis for:  PSA-Test  DR-Exam  Prostate cancer incidence

Methodology BRFSS  Designed to monitor trends in: –Risk behaviors –Chronic diseases –Prostate cancer conditions  Response rates vary for subgroups –State of Florida rates range from 87 to 98 percent

Demographic Characteristics  Selected population –Florida –Male (18-99) –N=2,437

Demographic Characteristics

Health Characteristic

Health Behavior

Health Utilization

Results Bivariate Analysis Variable Yes (%) No (%) Race White White Black Black Hispanic Hispanic

Results Bivariate Analysis Variable Yes (%) No (%) Age<40>

Results Bivariate Analysis Variable Yes (%) No (%) General Health Good Good Fair Fair Poor Poor

Results VariablePSA-TestDR-ExamPC Race White White Black Black Hispanic Hispanic Odds Ratios for factors that affect the probability of being tested and diagnosed for prostate cancer (P<0.05).

Results VariablePSA-TestDR-ExamPC Age <40 <40 >40 > Odds Ratios for factors that affect the probability of being tested and diagnosed for prostate cancer (P<0.05).

Results VariablePSA-Test DR- Exam PC Education Elementary Elementary High School High School College College Odds Ratios for factors that affect the probability of being tested and diagnosed for prostate cancer (P<0.05).

Results VariablePSA-TestDR-ExamPC Health Plan No No Yes Yes Odds Ratios for factors that affect the probability of being tested and diagnosed for prostate cancer (P<0.05 ).

Conclusion  The study shows that African American men have higher prostate cancer incidents consistent with other findings  Age, race and education are important risk factors associated with prostate cancer incidence.

Limitations  Non-disease specific data  Analysis of secondary data

Recommendation  Increase awareness of the disease - African American Men - African American Men - Legislature - Legislature - General community - General community

Acknowledgements  IPH Faculty & Staff  DR. Folakemi Odedina  ESAP Faculty, Staff & Students  Good Friends  Family

QUESTIONS ????