title: An examination of variations in the uptake of prostate cancer screening within and between the countries of the EU-27.
abstract: OBJECTIVE
  Prostate specific antigen (PSA) testing as a part of a prostate cancer control strategy is the subject of much debate. This paper examines variations in the uptake of PSA testing across Europe and the role of individual and contextual variables in explaining this variation.
  
  
  METHODS
  Data were taken from Eurobarometer 66.2 "Health in the European Union" 2006 on self-reported uptake of screening. Data related to men across the EU-27 and Croatia, aged 40 and over (N=6986). A logistic regression analysis examines the role of individual characteristics across and within the countries.
  
  
  RESULTS
  A range of individual characteristics were found to be statistically significant predictors of uptake including education, marital status, and smoking status. Socio-economic status (SES) was also a statistically significant predictor of the likelihood of screening. Variation across countries in uptake was evident; importantly a significant role was accorded primary care in explaining variation in uptake.
  
  
  CONCLUSIONS
  Uptake of PSA testing varies considerably within and across European countries. Differences within states relate to the characteristics of individuals offered tests and differences between states, to the system of primary care in operation. Given the significant welfare losses implicit in the evident variations the role of primary care warrants further investigation.
authors.affiliation: Cairnes School of Business and Economics, NUI Galway, Galway, Ireland.
authors.forename: Richeal
authors.initials: R
authors.lastname: Burns
authors.forename: Brendan
authors.initials: B
authors.lastname: Walsh
authors.forename: Stephen
authors.initials: S
authors.lastname: O'Neill
authors.forename: Ciaran
authors.initials: C
authors.lastname: O'Neill
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D004522:Educational Status; D005060:Europe / Q000453:epidemiology; D005062:European Union / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors
chemical_list: D017430:Prostate-Specific Antigen