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Psychosocial variables that influence a man's decision to undergo prostate cancer (CaP) screening have not been well identified. In the December 2008 issue of Cancer Epidemiology, Biomarkers and Prevention, Lauren Wallner and associates use the Olmsted County database to explore this issue.
In January 1990, a random sample of all male Olmsted County, Minnesota residents was generated as a population-based cohort study of urinary health in men. Of 3,874 eligible men, 2,115 agreed to participate in an in-home interview in 1990 and biennially thereafter. The researchers of this study sought to identify psychosocial factors that influenced the decision to undergo CaP screening. Screening frequency was defined as the number of digital rectal exams (DREs) and PSA testing events. The frequency of DREs was assessed from 1989 to 1996 via medical record abstraction. Frequent DRE testing was defined as those men in the upper 25th percentile of screening frequency with a defining cut point of >4 DREs. PSA tests done from 1989 to 1998 were included and frequent PSA testing was defined as men in the upper 25th percentile with a defining cut point of >3 PSA tests. Measures of family history of CaP and worry or concern about CaP were collected via questionnaire. Marital status was obtained by questionnaire and was categorized as married or living together versus single, divorced, separated, or widowed.
Median age of the population was 51.9 years and median number of PSA and/or DRE tests was 4. Most men had completed high school (89.3%) and were married or living with a partner (85%). A family history of CaP was reported in 9.4% and 10.3% had a worry about CaP. A family history of CaP and worry or concern about CaP was associated with a significantly higher frequency of CaP screening. Men with a family history of CaP were 1.4 times more likely to have frequent screening compared to men without a family history of CaP. Worry or concern about CaP significantly increased the odds of frequent CaP screening with a multivariable adjusted odds ration of 1.5. Older age, a high school education or having a partner were also associated with increased odds of frequent screening. Interestingly, age did not modify the association between family histories of, or worry about CaP and frequent screening. Married men with a family history of CaP had 1.7 greater odds of frequent CaP screening compared with married men with no family history of CAP. Men who were single, divorced, separated, or widowed and had a family history of CaP did not have increased odds of frequent screening. Marital status did not modify the association between worry or concern about CaP and frequent CaP screening.
Wallner LP, Sarma AV, Lieber MM, St Sauver JL, Jacobson DJ, McGree ME, Gowan ME, Jacobsen SJ
Cancer Epidemiol Biomarkers Prev. 2008 Dec;17(12):3588-92.
doi:10.1158/1055-9965.EPI-08-0050
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