Trends in prostate-specific antigen test use, 2000-2005

Abstract

Objective: This study examined prostate-specific antigen (PSA) test use among men and identified sociodemographic and health-related characteristics associated with its use over time.

Methods: The National Health Interview Survey collected information on PSA test use among 16,058 men > or = 40 years of age in 2000 and 2005. We examined two outcomes: (1) having had a recent (within two years) screening PSA test and (2) having had three or more PSA tests in the past five years (to indicate frequent use).

Results: Marital status, family history of prostate cancer, and having seen a doctor in the past year differed over time in the unadjusted model. In the adjusted model, recent PSA screening decreased from 2000 to 2005 for single, never-married men, but increased for men with chronic diseases. Frequent PSA test use increased for men with a family history of prostate cancer, men with chronic diseases, and men who had seen a physician in the past year. Significant correlates of higher recent PSA test use included being older, married, and of black race/ethnicity; having higher levels of education and income, health-care coverage, and a usual place of health care; and increased comorbidity.

Conclusion: Major organizations are not in agreement about the efficacy of prostate cancer screening; however, men > or = 40 years of age continue to use the PSA test. Both recent screening and frequent testing showed variability during the study period and may have implications for the ongoing randomized clinical trials that are expected to clarify whether early detection of prostate cancer with PSA testing increases survival.