Lifetime and Recent Prostate Specific Antigen (PSA) Screening of Men for Prostate Cancer in Canada

• Published in: Canadian journal of public health 2006-05, Vol.97 (3), p.171-176
• Main Authors: Beaulac, Jennifer A., Fry, Richard N., Onysko, Jay
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Age groups; Aged; Algorithms; Anti smoking movements; Antigens; Biological and medical sciences; Blood tests; Canada; Cancer screening; Clinical medicine; Confidence intervals; Cross-Sectional Studies; Decision making; Guideline Adherence; Gynecology. Andrology. Obstetrics; Health Care Surveys; Health services; Health surveys; Humans; Male; Male genital diseases; Mass Screening - standards; Mass Screening - statistics & numerical data; Medical records; Medical sciences; Medical treatment; Middle Aged; Miscellaneous; Nephrology. Urinary tract diseases; Patient Acceptance of Health Care - statistics & numerical data; Practice Guidelines as Topic; Prostate; Prostate cancer; Prostate-Specific Antigen; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - prevention & control; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Recommendations; RESEARCH/RECHERCHE; Risk factors; Screening tests; Testing; Tests; Tumors; Tumors of the urinary system; Urinary tract. Prostate gland
• ISSN: 0008-4263; 1920-7476
• DOI: 10.1007/bf03405578

Background: In spite of national guidelines which do not recommend prostate specific antigen (PSA) screening for prostate cancer or are inconclusive, Canadian men may be accessing the screening test. Methods: For the purpose of informing prostate screening policy, cross-sectional selfreported data from the Canadian Community Health Survey (2000-2001) were analyzed to determine the lifetime and recent PSA screening prevalence of Canadian men aged 50 and older with no prostate cancer, and to explore the socio-demographic characteristics associated with ever being screened. Multivariate binomial regression analyses were used to calculate prevalence rate ratios as a measure of association between respondents' characteristics and PSA screening behaviour. Results: Almost half of Canadian men over the age of 50 years (47.5%; 95% CI=46.4-48.5) reported receiving PSA screening during their lifetime. Seventy-two percent (71.8%) of PSA screening was performed within one year prior to the survey or recently. Lifetime prevalence was highest among men aged 60-69 (53.1%; 95% CI=51.1-55.1). Next to advanced age, having a family doctor was the most predictive of screening behaviour (PRR=1.83, p≤0.01). Black ethnicity, a risk factor for prostate cancer, failed to be predictive of screening (PRR=1.04, NS). Not speaking French or English was strongly associated with not obtaining a PSA screen (PRR=0.66, p≤0.01). Interpretation: Our finding that Canadian men commonly reported PSA screening for prostate cancer is not congruent with national guidelines. While we wait for randomized controlled trial evidence of the effectiveness of PSA screening in reducing mortality due to prostate cancer, PSA screening has emerged as a public health issue. Contexte : Bien que les lignes directrices nationales ne recommandent pas le dépistage de l'antigène prostatique spécifique (PSA) pour le cancer de la prostate, ou jugent que ce dépistage est peu concluant, il est possible que les hommes canadiens subissent quand même ce test de dépistage. Méthode : Pour améliorer la politique sur le dépistage du cancer de la prostate, nous avons analysé les données transversales autodéclarées tirées de l'Enquête sur la santé dans les collectivités canadiennes (2000-2001) afin de déterminer la prévalence du test PSA, récemment et au cours de la vie, chez les hommes canadiens de 50 ans et plus n'ayant pas de cancer de la prostate. Nous voulions aussi analyser les caractéristiques sociodémographiques associées