Scales Charles D, Antonelli Jodi, Curtis Lesley H, Schulman Kevin A, Moul Judd W
Duke Prostate Center, Division of Urology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina 27710, USA.
Cancer. 2008 Sep 15;113(6):1315-23. doi: 10.1002/cncr.23667.
Disagreement exists on the use of prostate-specific antigen (PSA) tests for cancer-risk stratification in young men in the United States. Little is known about the use of PSA testing in these men. To understand policy implications of risk stratification, the authors sought to characterize PSA use among young men.
The authors used the 2002 Behavioral Risk Factor Surveillance System to study prostate-cancer screening in a representative sample of men aged 40 years and older (n = 58,511). The primary outcome was self-report of a PSA test in the previous year.
Among men aged 40 to 49 years, 22.5% (95% confidence interval [CI], 21.5-23.5) reported having had a PSA test in the previous year, compared with 53.7% (95% CI, 52.8-54.7; P < .001) of men aged >or=50 years. When sociodemographic characteristics were statistically controlled, young, black, non-Hispanic men were more likely than young, white, non-Hispanic men to report having had a PSA test in the previous year (odds ratio [OR], 2.42; 95% CI, 1.95-3.01; P < .001). In young men, annual household income >or=USD 35,000 (OR, 1.50; 95% CI, 1.26-1.78; P < .001) and an ongoing relationship with a physician (OR, 2.52; 95% CI, 2.06-3.07; P < .001) were associated with PSA testing.
One-fifth of young men reported having had a PSA test within the previous year. Young, black, non-Hispanic men are more likely than young, white, non-Hispanic men to report having had a PSA test, although screening in this high-risk group remains suboptimal.
在美国，对于使用前列腺特异性抗原（PSA）检测对年轻男性进行癌症风险分层存在分歧。对于这些男性使用PSA检测的情况知之甚少。为了解风险分层的政策影响，作者试图描述年轻男性中PSA检测的使用情况。
作者使用2002年行为危险因素监测系统，对40岁及以上男性的代表性样本（n = 58,511）进行前列腺癌筛查研究。主要结果是前一年进行PSA检测的自我报告。
在40至49岁的男性中，22.5%（95%置信区间[CI]，21.5 - 23.5）报告前一年进行了PSA检测，而50岁及以上男性的这一比例为53.7%（95% CI，52.8 - 54.7；P <.001）。在对社会人口统计学特征进行统计学控制后，年轻的非西班牙裔黑人男性比年轻的非西班牙裔白人男性更有可能报告前一年进行了PSA检测（优势比[OR]，2.42；95% CI，1.95 - 3.01；P <.001）。在年轻男性中，家庭年收入≥35,000美元（OR，1.50；95% CI，1.26 - 1.78；P <.001）以及与医生保持持续关系（OR，2.52；95% CI，2.06 - 3.07；P <.001）与PSA检测相关。
五分之一 的年轻男性报告前一年进行了PSA检测。年轻的非西班牙裔黑人男性比年轻的非西班牙裔白人男性更有可能报告进行了PSA检测，尽管该高危人群的筛查仍不理想。
