Abstract
BackgroundThe central role of prostate-specific antigen (PSA) testing in the diagnosis of prostate cancer leads to the possibility that observational studies that report associations between risk factors and prostate cancer could be affected by detection bias. This study aims to investigate whether reported risk factors for prostate cancer are associated with PSA testing in a large middle-aged population-based cohort in the UK. MethodsThe cross-sectional association between a wide range of sociodemographic, lifestyle, dietary and health characteristics with PSA testing was examined in 212,039 men aged 40–69 years in UK Biobank. ResultsA total of 62,022 (29%) men reported they had ever had a PSA test. A wide range of factors was associated with a higher likelihood of PSA testing including age, height, education level, family history of prostate cancer, black ethnic origin, not being in paid/self-employment, living with a wife or partner, having had a vasectomy, being diagnosed with cancer or hypertension and having a high dietary intake of cereal, cooked and salad/raw vegetables, fresh fruit and tea. Conversely, socioeconomic deprivation, Asian ethnic origin, current smoking, low alcohol intake, high body-mass index, high coffee consumption and being diagnosed with diabetes, heart disease or stroke were associated with a lower likelihood of PSA testing. ConclusionsA variety of sociodemographic, lifestyle and health-related characteristics are associated with PSA testing, suggesting that observed associations of some of these traits with risk for prostate cancer in epidemiological studies may be, at least partially, due to detection bias.
Highlights
The only well-established lifestyle and demographic risk factors for prostate cancer are advanced age, being of black ethnic origin and having a family history of the disease
A wide range of other sociodemographic, behavioural, dietary and health-related characteristics have been reported to be associated with increased prostate cancer risk [1], these findings are less well established between studies and across populations
Age was most strongly associated with prostate-specific antigen (PSA) testing
Summary
The only well-established lifestyle and demographic risk factors for prostate cancer are advanced age, being of black ethnic origin and having a family history of the disease. A wide range of other sociodemographic, behavioural, dietary and health-related characteristics have been reported to be associated with increased prostate cancer risk [1], these findings are less well established between studies and across populations. This inconsistency may, in part, be due to detection bias if these characteristics are associated with the likelihood of having. The aim of this study was to examine the associations between a wide range of sociodemographic, lifestyle and health-related characteristics and PSA testing in a large UK cohort without a routine screening programme, with a particular focus on established or possible risk factors for prostate cancer.
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