Self-reported prevalence of prostate-specific antigen testing in South Australia: a community study.
OBJECTIVE
To determine the prevalence and other characteristics of self-reported blood testing (prostate-specific antigen [PSA]) for prostate cancer in the community.


METHODS
Interview-based prevalence study.


METHODS
695 men aged 40 years and over in the Spring 1996 South Australian Health Omnibus survey of a probability sample of 3011 households, weighted to reflect the age and sex distribution of the South Australian population.


METHODS
Number of men who had a PSA test in the preceding 12 months; number of first tests; the person initiating and performing the test; knowledge of the next step if test result abnormal; number of men visiting doctor for lower urinary tract symptoms in the preceding 12 months.


RESULTS
20.3% of participants reported having a PSA test in the preceding 12 months; 62.1% were first tests. Prevalence of testing was highest in the age group 70-79 years (35.8%). Most tests were initiated by the general practitioner (41.2%) and by patients (35.7%). Of those tested, 45.3% had inadequate knowledge of the next step. Visiting a doctor for urinary symptoms was significantly associated with PSA testing (P < 0.001): 47.7% of men who visited a doctor for urinary symptoms had been tested compared with only 17.4% of those who did not visit the doctor for this problem. Only age and visiting a doctor for urinary symptoms were significant independent predictors of having a PSA test.


CONCLUSIONS
Investigation of lower urinary tract symptoms contributed substantially to PSA testing, and those tested did not adequately understand the consequences. Our findings suggest a need for a better framework for PSA testing in general practice, including all important elements of decision-making, such as evidence and patient preference, as well as the means to ensure adequate patient counselling before testing.
Division of Surgery, Repatriation General Hospital, Daw Park, SA. spinncb@rgh.edu.au
C B
CB
Pinnock
D P
DP
Weller
V R
VR
Marshall
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003710:Demography; D005194:Family Practice / Q000706:statistics & numerical data; D006266:Health Education / Q000592:standards / Q000706:statistics & numerical data; D006306:Health Surveys; D006403:Hematologic Tests / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000706:statistics & numerical data; D015995:Prevalence; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D012650:Self Disclosure; D013021:South Australia / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014570:Urologic Diseases / Q000097:blood
D017430:Prostate-Specific Antigen