Abstract
Population-wide screening for prostate cancer remains a controversial topic, given the need for an individualized approach to patients regarding the risks and benefits of prostate-specific antigen testing and digital rectal examination. The aim of this study was to investigate the prevalence of, and factors associated with, prostate examination among men aged 45 or older. Cross-sectional population-based study developed in the city of Rio Grande (RS), Brazil. The outcome of interest was a history of prostate examination (prostate-specific antigen testing or digital rectal examination). The following independent variables were analyzed: age group, skin color, marital status, schooling, economic level, leisure-time physical activity, smoking habits, excessive alcohol consumption, overweight, health insurance, visits to the doctor during the preceding year, hypertension and diabetes. After a two-stage sampling process, the final sample consisted of 281 male individuals. The prevalence of a history of prostate-specific antigen testing or digital rectal examination was 68.3% (95% confidence interval (CI): 62.2 to 74.5). The highest prevalence rates were observed among men aged 70 years or older (88%) and the lowest among smokers (36%). The following characteristics were found to be associated with the outcome: advanced age; marital status other than single; more schooling and higher economic status; practicing physical activity; non-smoking habits; overweight; having health insurance; and having visited a doctor during the preceding year. Approximately two thirds of the study population had been screened for prostate examination, mostly older individuals, with higher socioeconomic status and a healthier lifestyle.
Highlights
Population-wide screening for prostate cancer remains a controversial topic, given the need for an individualized approach to patients regarding the risks and benefits of prostate-specific antigen testing and digital rectal examination
The final sample size consisted of 281 male individuals aged 45 years or older (mean: 59.3 years; standard deviation (SD): 10.6; maximum age: 96 years)
The highest prevalence rates of for prostate examination were observed among men aged 70 years or older (88.2%) and the lowest among smokers (36.2%) (Table 2)
Summary
Population-wide screening for prostate cancer remains a controversial topic, given the need for an individualized approach to patients regarding the risks and benefits of prostate-specific antigen testing and digital rectal examination. The combination of prostate-specific antigen testing and digital rectal examination has been considered to be an effective approach, since 18% to 45% of tumors would not have been diagnosed, had one of these two methods not been performed.[3] The American Cancer Society advises that, among men whose life expectancy exceeds 10 years, screening should be done annually, through informed consent. This should be started at the age of 50 years for those at moderate risk; at the age of 45 for those at high risk (afro-descendants and individuals with a history of prostate cancer in first-degree family members at ages younger than 65 years); and at the age of 40 for those at very high risk (multiple family members diagnosed with prostate cancer before the age of 65).[4]. CONCLUSION: Approximately two thirds of the study population had been screened for prostate examination, mostly older individuals, with higher socioeconomic status and a healthier lifestyle
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