Prostate-specific antigen screening among young men in the United States

Duke Prostate Center, Division of Urology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina 27710, USA.
Cancer (Impact Factor: 4.89). 09/2008; 113(6):1315-23. DOI: 10.1002/cncr.23667
Source: PubMed


Disagreement exists on the use of prostate-specific antigen (PSA) tests for cancer-risk stratification in young men in the United States. Little is known about the use of PSA testing in these men. To understand policy implications of risk stratification, the authors sought to characterize PSA use among young men.
The authors used the 2002 Behavioral Risk Factor Surveillance System to study prostate-cancer screening in a representative sample of men aged 40 years and older (n = 58,511). The primary outcome was self-report of a PSA test in the previous year.
Among men aged 40 to 49 years, 22.5% (95% confidence interval [CI], 21.5-23.5) reported having had a PSA test in the previous year, compared with 53.7% (95% CI, 52.8-54.7; P < .001) of men aged >or=50 years. When sociodemographic characteristics were statistically controlled, young, black, non-Hispanic men were more likely than young, white, non-Hispanic men to report having had a PSA test in the previous year (odds ratio [OR], 2.42; 95% CI, 1.95-3.01; P < .001). In young men, annual household income >or=USD 35,000 (OR, 1.50; 95% CI, 1.26-1.78; P < .001) and an ongoing relationship with a physician (OR, 2.52; 95% CI, 2.06-3.07; P < .001) were associated with PSA testing.
One-fifth of young men reported having had a PSA test within the previous year. Young, black, non-Hispanic men are more likely than young, white, non-Hispanic men to report having had a PSA test, although screening in this high-risk group remains suboptimal.

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Available from: Judd W Moul, Nov 17, 2014
    • "of as protective factor (high SES) is better conceptualized here as a risk factor. PSA testing is more common among high SES men (Nijs et al., 2000; Scales et al., 2008) and this contributes to the evidence that men who have higher SES have higher incidence of PCa but are also more likely to have localized and/or low grade at diagnosis and lower mortality (Rundle et al., 2013). Thus, higher SES may lead to higher medical surveillance and screening, including cancer screening with unclear benefits and clear harms. "
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