Korean J Urol.  2010 Jun;51(6):391-397.

Predictors of PSA Screening Among Men Over 40 Years of Age Who Had Ever Heard about PSA

• Seo HS
• Lee NK

Abstract

PURPOSE
The purpose of this study was to investigate social and behavioral factors associated with prostate-specific antigen (PSA) screening in men in California, United States, who were over 40 years of age and had ever heard about PSA screening.
MATERIALS AND METHODS
This survey was administered as a random-digit-dialing telephone survey to produce reliable estimates of medium-sized counties. It surveyed 42,000 households and interviewed 58,407 people randomly. It considered socioeconomic status and health behavior as affecting PSA screening. Access to health care was measured as having regular health care access. The main outcome measure was self-report of ever having undergone PSA screening at least once in the respondent's lifetime.
RESULTS
Of 8,864 respondents, 82.2% were White, 7.7% were Latin, 4.2% were African American, and 5.9% were Asian. The respondents' mean age was 60.13 years. Age was the significant factor for PSA screening. Respondents aged 50-59 years were 3.5 times as likely to have undergone PSA screening as were those aged 40-49 years (OR=3.49, p< or =0.001). Race was not statistically significant after considering other factors. People who had never married had statistically significantly lower screening than did people who were married (OR=0.71, p=0.001). Poverty levels were statistically significant in both the unadjusted and the adjusted analysis. People who had no regular health care access were much less likely to have undergone PSA screening than were people who had regular health care access (OR=0.22, p=0.001).
CONCLUSIONS
The likelihood of PSA screening was positively associated with increased age, marital status (married), higher socioeconomic status (higher federal poverty level and higher educational attainment), and health care access. However, there was no statistically significant association of PSA screening with race, employment, exercise, smoking, or drinking status.

Keyword

Mass screening; Prostate-specific antigen

MeSH Terms

Aged
Asian Continental Ancestry Group
California
Continental Population Groups
Surveys and Questionnaires
Delivery of Health Care
Drinking
Employment
Family Characteristics
Health Behavior
Health Services Accessibility
Humans
Male
Marital Status
Mass Screening
Outcome Assessment (Health Care)
Poverty
Prostate-Specific Antigen
Single Person
Smoke
Smoking
Social Class
Telephone
United States
Prostate-Specific Antigen
Smoke

Reference

1. Klein EA, Platz EA, Thompson IM. Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Epidemiology, etiology, and prevention of prostate cancer. Campbell-Walsh urology. 2007. 9th ed. Philadelphia: Saunders;p. 2854–2873.

2. Sirovich BE, Schwartz LM, Woloshin S. Screening men for prostate and colorectal cancer in the United States: does practice reflect the evidence? JAMA. 2003; 289:1414–1420. PMID: 12636464.

3. Smith RA, von Eschenbach AC, Wender R, Levin B, Byers T, Rothenberg D, et al. American Cancer Society guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal, and endometrial cancers. Also: update 2001--testing for early lung cancer detection. CA Cancer J Clin. 2001; 51:38–75. PMID: 11577479.

4. Smith DS, Bullock AD, Catalona WJ, Herschman JD. Racial differences in a prostate cancer screening study. J Urol. 1996; 156:1366–1369. PMID: 8808873.

5. Liu L, Cozen W, Bernstein L, Ross RK, Deapen D. Changing relationship between socioeconomic status and prostate cancer incidence. J Natl Cancer Inst. 2001; 93:705–709. PMID: 11333293.

6. Ross LE, Coates RJ, Breen N, Uhler RJ, Potosky AL, Blackman D. Prostate-specific antigen test use reported in the 2000 National Health Interview Survey. Prev Med. 2004; 38:732–744. PMID: 15193893.

7. Jones BA, Liu WL, Araujo AB, Kasl SV, Silvera SN, Solar-Vila H, et al. Explaining the race difference in prostate cancer stage at diagnosis. Cancer Epidemiol Biomarkers Prev. 2008; 17:2825–2834. PMID: 18829446.

8. Resnick MJ, Canter DJ, Guzzo TJ, Bruker BM, Bergey M, Sonnad SS, et al. Does race affect postoperative outcomes in patients with low-risk prostate cancer who undergo radical prostatectomy? Urology. 2009; 73:620–623. PMID: 19100607.

9. Stattin P, Holmberg E, Bratt O, Adolfsson J, Johansson JE, Hugosson J. Surveillance and deferred treatment for localized prostate cancer. Population based study in the National Prostate Cancer Register of Sweden. J Urol. 2008; 180:2423–2429. PMID: 18930283.

10. Clegg LX, Reichman ME, Miller BA, Hankey BF, Singh GK, Lin YD, et al. Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study. Cancer Causes Control. 2009; 20:417–435. PMID: 19002764.

11. Pearlman DN, Rakowski W, Ehrich B, Clark MA. Breast cancer screening practices among black, Hispanic, and white women: reassessing differences. Am J Prev Med. 1996; 12:327–337. PMID: 8909641.

12. Phillips KA, Kerlikowske K, Baker LC, Chang SW, Brown ML. Factors associated with women's adherence to mammography screening guidelines. Health Serv Res. 1998; 33:29–53. PMID: 9566176.

13. Potosky AL, Breen N, Graubard BI, Parsons PE. The association between health care coverage and the use of cancer screening tests. Results from the 1992 National Health Interview Survey. Med Care. 1998; 36:257–270. PMID: 9520952.

14. Breen N, Wagener DK, Brown ML, Davis WW, Ballard-Barbash R. Progress in cancer screening over a decade: results of cancer screening from the 1987, 1992, and 1998 National Health Interview Surveys. J Natl Cancer Inst. 2001; 93:1704–1713. PMID: 11717331.