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Canadian Journal of Public Health

, Volume 97, Issue 3, pp 171–176 | Cite as

Lifetime and Recent Prostate Specific Antigen (PSA) Screening of Men for Prostate Cancer in Canada

  • Jennifer A. Beaulac
  • Richard N. Fry
  • Jay Onysko
Research

Abstract

Background: In spite of national guidelines which do not recommend prostate specific antigen (PSA) screening for prostate cancer or are inconclusive, Canadian men may be accessing the screening test.

Methods: For the purpose of informing prostate screening policy, cross-sectional self-reported data from the Canadian Community Health Survey (2000–2001) were analyzed to determine the lifetime and recent PSA screening prevalence of Canadian men aged 50 and older with no prostate cancer, and to explore the socio-demographic characteristics associated with ever being screened. Multivariate binomial regression analyses were used to calculate prevalence rate ratios as a measure of association between respondents’ characteristics and PSA screening behaviour.

Results: Almost half of Canadian men over the age of 50 years (47.5%; 95% CI=46.4–48.5) reported receiving PSA screening during their lifetime. Seventy-two percent (71.8%) of PSA screening was performed within one year prior to the survey or recently. Lifetime prevalence was highest among men aged 60–69 (53.1%; 95% CI=51.1–55.1). Next to advanced age, having a family doctor was the most predictive of screening behaviour (PRR=1.83, p≤0.01). Black ethnicity, a risk factor for prostate cancer, failed to be predictive of screening (PRR=1.04, NS). Not speaking French or English was strongly associated with not obtaining a PSA screen (PRR=0.66, p≤0.01).

Interpretation: Our finding that Canadian men commonly reported PSA screening for prostate cancer is not congruent with national guidelines. While we wait for randomized controlled trial evidence of the effectiveness of PSA screening in reducing mortality due to prostate cancer, PSA screening has emerged as a public health issue.

MeSH terms

Prostatic neoplasms prostate-specific antigen mass screening cross-sectional studies practice guidelines 

Résumé

Contexte: Bien que les lignes directrices nationales ne recommandent pas le dépistage de l’antigène prostatique spécifique (PSA) pour le cancer de la prostate, ou jugent que ce dépistage est peu concluant, il est possible que les hommes canadiens subissent quand même ce test de dépistage.

Méthode: Pour améliorer la politique sur le dépistage du cancer de la prostate, nous avons analysé les données transversales autodéclarées tirées de l’Enquête sur la santé dans les collectivités canadiennes (2000–2001) afin de déterminer la prévalence du test PSA, récemment et au cours de la vie, chez les hommes canadiens de 50 ans et plus n’ayant pas de cancer de la prostate. Nous voulions aussi analyser les caractéristiques sociodémographiques associées au fait d’avoir subi ce test à un moment ou à un autre. Au moyen d’analyses de régression multivariable binomiales, nous avons calculé le rapport des taux de prévalence (RTP) pour mesurer les liens entre les caractéristiques des répondants et leur schéma d’utilisation du test PSA.

Résultats: Près de la moitié des hommes canadiens de plus de 50 ans (47,5 %; IC de 95 % =46,4–48,5) ont dit avoir subi le test PSA au cours de leur vie. Soixante-douze p. cent (71,8 %) des tests PSA avaient été administrés moins d’un an avant l’enquête, ou récemment. La prévalence de ce test au cours de la vie était la plus élevée chez les hommes de 60 à 69 ans (53,1 %; IC de 95 % = 51,1–55,1). Après l’âge avancé, le fait d’avoir un médecin de famille était le prédicteur le plus important de l’utilisation du test (RTP = 1,83, p≤0,01). Le fait d’être Noir, qui est un facteur de risque pour le cancer de la prostate, n’était toutefois pas une variable prédictive de l’utilisation du test (RTP = 1,04, aucun écart statistique). Le fait de ne parler ni français, ni anglais était fortement associé à la non-utilisation du test PSA (RTP = 0,66, p≤0,01).

Interprétation: Nous avons constaté que les hommes canadiens déclarent communément avoir subi un test PSA pour le dépistage du cancer de la prostate, ce qui ne concorde pas avec les lignes directrices nationales. En attendant que des études randomisées et contrôlées prouvent l’efficacité du test PSA pour réduire la mortalité due au cancer de la prostate, ce test commence à être vu comme un problème de santé publique.

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Copyright information

© The Canadian Public Health Association 2006

Authors and Affiliations

  • Jennifer A. Beaulac
    • 1
  • Richard N. Fry
    • 1
  • Jay Onysko
    • 1
  1. 1.Centre for Chronic Disease Prevention and ControlPublic Health Agency of CanadaOttawaCanada

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