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Association between Literacy, Compliance with Prostate Cancer Screening, and Cancer Aggressiveness: Results from a Brazilian Screening Study
Tobias-Machado, Marcos; Carvalhal, Gustavo F.; Freitas Jr., Celso H.; Reis, Rodolfo B. dos; Reis, Leonardo O.; Nogueira, Lucas; Machado, Roberto D.; Magnabosco, Wesley; Vieira, Rene A. C.; Mauad, Edmundo C.; Carvalho, Andre L.; Faria, Eliney F..
  • Tobias-Machado, Marcos; Faculdade de Medicina do ABC (MTM). Department of Urology.
  • Carvalhal, Gustavo F.; Faculdade de Medicina do ABC (MTM). Department of Urology.
  • Freitas Jr., Celso H.; Faculdade de Medicina do ABC (MTM). Department of Urology.
  • Reis, Rodolfo B. dos; Faculdade de Medicina do ABC (MTM). Department of Urology.
  • Reis, Leonardo O.; Faculdade de Medicina do ABC (MTM). Department of Urology.
  • Nogueira, Lucas; Faculdade de Medicina do ABC (MTM). Department of Urology.
  • Machado, Roberto D.; Faculdade de Medicina do ABC (MTM). Department of Urology.
  • Magnabosco, Wesley; Faculdade de Medicina do ABC (MTM). Department of Urology.
  • Vieira, Rene A. C.; Faculdade de Medicina do ABC (MTM). Department of Urology.
  • Mauad, Edmundo C.; Faculdade de Medicina do ABC (MTM). Department of Urology.
  • Carvalho, Andre L.; Faculdade de Medicina do ABC (MTM). Department of Urology.
  • Faria, Eliney F.; Faculdade de Medicina do ABC (MTM). Department of Urology.
Int. braz. j. urol ; 39(3): 328-334, May/June/2013. tab
Article in English | LILACS | ID: lil-680090
ABSTRACT
Purpose Little is known about the effects of literacy levels on prostate cancer screening. This study evaluates the association between literacy, compliance with screening, and biopsy findings in a large Brazilian screening study. Materials and Methods We analyzed 17,571 men screened for PCa with digital rectal examination (DRE) and total and free prostate-specific antigen (PSA) from January 2004 to December 2007. Of those, 17,558 men had information regarding literate status. Full urological evaluation in a specialized cancer center was recommended in the case of a) suspicious DRE, b) PSA > 4.0 ng/mL, or c) PSA 2.5-3.9 ng/mL and free/total PSA (f/tPSA) ratio < 15%. Transrectal ultrasound guided prostate biopsy (14 cores) was performed upon confirmation of these findings after the patient's consent. Patients' compliance with screening recommendations and biopsy results were evaluated according to literacy levels. Results an abnormal PSA, a suspicious DRE, or both were present in 73.2%, 19.7%, and 7.1% of those men who underwent biopsy, respectively. PCa was diagnosed in 652 men (3.7%). Previous PSAs or DREs were less common among illiterate men (p < 0.0001). Additionally, illiterate men were less prone to attend to further evaluations due to an abnormal PSA or DRE (p < 0.0001). PSA levels > 10 mg/mL (p = 0.03), clinical stage > T2a (p = 0.005), and biopsy Gleason > 7 (p = 0.02) were more common among illiterate men. Conclusions In a screened population, literacy levels were associated with prior PCa evaluations and with compliance with screening protocols. Illiterate men were at higher risk of being diagnosed with more advanced and aggressive PCa. .
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Full text: Available Index: LILACS (Americas) Main subject: Prostatic Neoplasms / Mass Screening / Health Literacy Type of study: Diagnostic study / Etiology study / Practice guideline / Prognostic study / Risk factors / Screening study Limits: Aged / Aged80 / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2013 Type: Article

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Full text: Available Index: LILACS (Americas) Main subject: Prostatic Neoplasms / Mass Screening / Health Literacy Type of study: Diagnostic study / Etiology study / Practice guideline / Prognostic study / Risk factors / Screening study Limits: Aged / Aged80 / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2013 Type: Article