Search

Abstract Background This cross‐sectional study explored how masculinity beliefs may influence colorectal cancer (CRC) screening participation among ethnic subgroups of screening‐age–eligible (45–75 years) Hispanic/Latino men. Methods Using a consumer panel, we recruited self‐identified Hispanic/Latino men fluent in English or Spanish, and residing in Florida, New York, or Texas. The Masculinity Barriers to Medical Care (MBMC) scale and its six subscales were used to assess masculinity beliefs. Multivariable logistic regression was used to estimate the association between MBMC and CRC screening participation, adjusting for Hispanic/Latino subgroup, marital status, survey language, age group, and health insurance status. Results were then stratified by Hispanic/Latino subgroup. Results Of the participants (n=611), approximately 31% identified as Puerto Rican, 30% as other Hispanic/Latino, 26% as Mexican, and 14% as Cuban; 63% had ever been screened for CRC. We found no differences in the prevalence of screening participation by Hispanic/Latino subgroup. The majority of participants had completed both a stool‐based test and an exam‐based screening test (29.3%). After adjusting for confounding, MBMC reduced the odds of screening participation. Slight MBMC‐subscale differences were observed by Hispanic/Latino subgroup. For example, higher scores on the Restrictive Emotionality subscale were associated with a lower likelihood of screening participation among Puerto Rican men, but higher odds of screening for Cuban men. Conclusions Masculinity barriers to CRC screening may exist. Tailored interventions to address masculinity barriers among specific Latino subgroups may improve CRC screening uptake in this population.

Abstract Introduction The Oncotype Dx Genomic Prostate Score (GPS) is a 17‐gene relative expression assay that predicts adverse pathology at prostatectomy. We conducted a novel randomized controlled trial to assess the impact of GPS on urologist's treatment preference for favorable risk prostate cancer (PCa): active surveillance versus active treatment (i.e., prostatectomy/radiation). This is a secondary endpoint from the ENACT trial which recruited from three Chicago hospitals from 2016 to 2019. Methods Ten urologists along with men with very low to favorable‐intermediate risk PCa were included in the study. Participants were randomly assigned to standardized counseling with or without GPS assay. The main outcome was urologists' preference for active treatment at Visit 2 by study arm (GPS versus Control). Multivariable best‐fit binary logistic regressions were constructed to identify factors independently associated with urologists' treatment preference. Results Two hundred men (70% Black) were randomly assigned to either the Control (96) or GPS arm (104). At Visit 2, urologists' preference for prostatectomy/radiation almost doubled in the GPS arm to 29.3% (29) compared to 14.1% (13) in the Control arm (p = 0.01). Randomization to the GPS arm, intermediate NCCN risk level, and lower patient health literacy were predictors for urologists' preference for active treatment. Discussion Limitations included sample size and number of urologists. In this study, we found that GPS testing reduced urologists' likelihood to prefer active surveillance. Conclusions These findings demonstrate how obtaining prognostic biomarkers that predict negative outcomes before treatment decision‐making might influence urologists' preference for recommending aggressive therapy in men eligible for active surveillance.