38 PSA screening: How many men have undergone testing, and what factors determine its uptake?

Abstract

Background: Ad-hoc testing for prostate cancer with the PSA (Prostate Specific Antigen) test has increased since its introduction in 1989. PSA screening is generally not promoted, and patients have to pay for the cost of the test ($30) in some provinces. In the US, 75% of men over 50 years have had a PSA test, compared with 35% in Montreal. This study was carried out to find the current rate of PSA screening and factors associated with its use. Methods: Telephone survey of 801 individuals with more detailed questioning of men aged 45-75 years, Those with prostate cancer were excluded, and the remainder asked a series of 11 questions, as well as demographic information. The margin of error is + 6.6% with a 95% confidence interval. Results: Two-hundred and nineteen men aged 45-75 years were further questioned. The median age was 55 years. 80% had some post-secondary education and 82% had internet access. Overall 70% had heard of the PSA test, and 74% of these knew that it was a blood test for prostate cancer, with other responses generally indicating a suitable alternate description. Fifty percent of men had had at least one PSA test previously, and this did not vary according to geographic location, internet access, or income level. The median number of PSA tests in the last five years was two. More with a university education had been tested (58%) compared with 45% high school (p=ns). Eighty-two percent of respondents said that they would be willing to pay to have the test done if research showed that the result could affect their chance of being alive in ten years time, and this figure rose to 91% if it were also provided free. 14% had a relative with prostate cancer and 34% a close friend and these respondents were more likely to have been tested (64 vs 33%). Conclusions: The utilization of PSA testing in BC is 50%. Awareness and understanding of the test appears high. If ongoing trials of PSA screening show a survival benefit and the test is funded over 90% of men say they would undergo screening.