title: Predictors of attendance for prostate-specific antigen screening tests and prostate biopsy.
abstract: BACKGROUND
  Little is known about factors influencing men's decisions to undergo screening and diagnostic tests for prostate cancer (PCa).
  
  
  OBJECTIVE
  Identify predictors of attendance for prostate-specific antigen (PSA) testing and prostate biopsy.
  
  
  METHODS
  Literature searches and interviews with men undergoing PSA testing and prostate biopsy formed the basis of a self-report questionnaire designed to identify predictors of health behaviour, which was completed by men eligible for PSA invitation and prostate biopsy. Multitrait scaling analyses established the final questionnaire content. This revised instrument was distributed to a new cohort of men before PSA testing and biopsy invitations were received. Ethical committee approval was obtained from Trent Multicentre Research Ethics Committee (MREC/01/4/025-21/06/2001).
  
  
  METHODS
  Predictors of health behaviour and attendance rates for PSA test or prostate biopsy were measured. Associations between questionnaire scores and health behaviour (PSA and prostate biopsy attendance) were examined using logistic regression.
  
  
  CONCLUSIONS
  The provisional 49-item health behaviour questionnaire was completed by 468 of 810 men (57.8%). Multitrait scaling refined the questionnaire to 26 items in six scales (A: health benefits, B: threats to health, C: barriers to testing, D: health intentions, E: external influences, F: current general health). A total of 1455 of 2657 men (54.8%) completed the revised instrument before invitations for PSA test or biopsy were received; 395 (43.4%) and 434 (91.6%) attended. Strong associations between men's health intentions (scale D) and PSA and biopsy attendance (odds ratio: 1.56 or 3.67, respectively; p<0.001) were observed with modest associations between the other five scales and attendance for PSA testing. Average questionnaire response rates represent the major limitation of this study.
  
  
  CONCLUSIONS
  Knowledge and beliefs about PCa and testing predict men's intentions and attendance for PSA testing and prostate biopsy. Understanding men's health behaviour is important for the management of patients seeking PSA testing in general practice.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK. kerry.avery@bristol.ac.uk
authors.forename: Kerry N L
authors.initials: KN
authors.lastname: Avery
authors.forename: Chris
authors.initials: C
authors.lastname: Metcalfe
authors.forename: Kavita
authors.initials: K
authors.lastname: Vedhara
authors.forename: J Athene
authors.initials: JA
authors.lastname: Lane
authors.forename: Michael
authors.initials: M
authors.lastname: Davis
authors.forename: David E
authors.initials: DE
authors.lastname: Neal
authors.forename: Freddie C
authors.initials: FC
authors.lastname: Hamdy
authors.forename: Jenny L
authors.initials: JL
authors.lastname: Donovan
authors.forename: Jane M
authors.initials: JM
authors.lastname: Blazeby
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003657:Decision Making; D055088:Early Detection of Cancer / Q000523:psychology*; D015438:Health Behavior; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D011795:Surveys and Questionnaires
chemical_list: D017430:Prostate-Specific Antigen