Lifetime and recent prostate specific antigen (PSA) screening of men for prostate cancer in Canada.
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 self-reported 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< or =0.01).


CONCLUSIONS
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.
Beaulac
Jennifer A
JA
Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, ON. Jennifer_beaulac@hc-sc.gc.ca
Fry
Richard N
RN
Onysko
Jay
J
D000328:Adult; D000367:Age Factors; D000368:Aged; D000465:Algorithms; D002170:Canada; D003430:Cross-Sectional Studies; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000517:prevention & control
D017430:Prostate-Specific Antigen