Wallner Lauren P, Sarma Aruna V, Lieber Michael M, St Sauver Jennifer L, Jacobson Debra J, McGree Michaela E, Gowan Monica E, Jacobsen Steven J
Departments of Epidemiology and Urology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
Cancer Epidemiol Biomarkers Prev. 2008 Dec;17(12):3588-92. doi: 10.1158/1055-9965.EPI-08-0050.
Prostate cancer is the second leading cause of cancer deaths among U.S. men. Early detection is associated with drastically improved 5-year survival rates. It is unclear, however, what psychosocial factors motivate or discourage men from taking advantage of both prostate-specific antigen (PSA) testing and digital rectal examination (DRE). The goal of the current study was to identify psychosocial factors that influence screening behavior for prostate cancer in a cohort of 2,447 men. In 1990, a randomly selected cohort of Caucasian men, ages 40 to 79 years, from Olmsted County, Minnesota, were enrolled in the study. These men completed a questionnaire containing queries on family history of prostate cancer, concern about getting prostate cancer, and marital status. Medical and laboratory records were reviewed to determine the number DREs (1989-1996) and PSA tests (1989-1998). Frequent screening was defined as the upper 25th percentile for number of DREs (>4) or PSAs (>3). Men who have a family history and men who worry or have concern about prostate cancer were more likely [odds ratio (OR), 1.5; 95% confidence interval (95% CI), 1.2-2.0 and OR, 1.9; 95% CI, 1.4-2.5] to seek screening compared with those without a family history or worry. The association between family history and frequent screening was similar in men who were married or living with someone (OR, 1.7; 95% CI, 1.2-2.2); however, it was reduced among men who live alone (OR, 0.6; 95% CI, 0.2-1.8). These data suggest that psychosocial factors such as family history, worry, or concern about prostate cancer and marital status may play an important role in men's decisions about prostate cancer screening.
前列腺癌是美国男性癌症死亡的第二大主要原因。早期检测与大幅提高的5年生存率相关。然而，尚不清楚哪些社会心理因素促使或阻碍男性利用前列腺特异性抗原（PSA）检测和直肠指检（DRE）。本研究的目的是确定影响2447名男性队列中前列腺癌筛查行为的社会心理因素。1990年，从明尼苏达州奥尔姆斯特德县随机选取了一组年龄在40至79岁之间的白人男性参与该研究。这些男性完成了一份问卷，其中包含有关前列腺癌家族史、对患前列腺癌的担忧以及婚姻状况的问题。审查医疗和实验室记录以确定直肠指检（1989 - 1996年）和PSA检测（1989 - 1998年）的次数。频繁筛查定义为直肠指检次数（>4次）或PSA检测次数（>3次）处于上四分位数。与没有家族史或担忧的男性相比，有家族史以及担心或关注前列腺癌的男性更有可能[比值比（OR）为1.5；95%置信区间（95%CI）为1.2 - 2.0，OR为1.9；95%CI为1.4 - 2.5]进行筛查。在已婚或与他人同居的男性中，家族史与频繁筛查之间的关联相似（OR为1.7；95%CI为1.2 - 2.2）；然而，在独居男性中这种关联减弱（OR为0.6；95%CI为0.2 - 1.8）。这些数据表明，诸如家族史、对前列腺癌的担忧或关注以及婚姻状况等社会心理因素可能在男性关于前列腺癌筛查的决策中起重要作用。
