Shavers Vickie L, Underwood Willie, Moser Richard P
National Cancer Institute, Division of Cancer Control and Population Science, Applied Research Program, Health Service and Economics Branch, 6130 Executive Blvd, MSC-7344, EPN Rm 4005, Bethesda, MD 20892-7344, USA.
J Natl Med Assoc. 2009 Jul;101(7):698-704. doi: 10.1016/s0027-9684(15)30979-2.
Men who do not perceive themselves to be at risk of developing and dying from prostate cancer may be less likely to utilize prostate cancer screening. This, coupled with variation among organizations in recommendations about screening with prostate-specific antigen (PSA), may contribute to confusion for providers and/or patients making prostate cancer screening decisions.
Data on 1075 African American, Hispanic, and non-Hispanic white male respondents to the 2003 Health Information National Trends Study (HINTS) were analyzed to examine the association among demographic characteristics, perception of the risk of developing prostate cancer, and PSA test utilization among men aged 45 or older.
African American men less frequently, while Hispanic men more frequently, perceived their risk of developing prostate cancer to be higher than the average same-age man compared to non-Hispanic white men. Overall, men who perceived their likelihood of getting prostate cancer as very low to moderate (OR, 0.42; 95% CI, 0.24-0.73) or perceived the likelihood compared to the average same age man as less or about as likely (OR, 0.47; 95% CI, 0.27-0.81) were significantly less likely to have received a PSA test in a model adjusted for age, marital status, education, and health insurance coverage.
These findings suggest that all men, but particularly African American and Hispanic men, could benefit from information regarding their specific risk of developing prostate cancer before making a decision about prostate cancer screening.
那些认为自己没有患前列腺癌及因前列腺癌死亡风险的男性可能不太会去进行前列腺癌筛查。这一点，再加上各机构在前列腺特异性抗原（PSA）筛查建议上的差异，可能会让医疗服务提供者和/或患者在做出前列腺癌筛查决策时感到困惑。
对参加2003年健康信息国家趋势研究（HINTS）的1075名非裔美国、西班牙裔和非西班牙裔白人男性受访者的数据进行分析，以研究45岁及以上男性的人口统计学特征、患前列腺癌风险的认知与PSA检测利用情况之间的关联。
与非西班牙裔白人男性相比，非裔美国男性较少认为自己患前列腺癌的风险高于同龄男性的平均水平，而西班牙裔男性则较多这样认为。总体而言，那些认为自己患前列腺癌的可能性非常低到中等（比值比，0.42；95%置信区间，0.24 - 0.73），或者认为与同龄男性平均水平相比可能性较低或大致相同（比值比，0.47；95%置信区间，0.27 - 0.81）的男性，在根据年龄、婚姻状况、教育程度和医疗保险覆盖情况进行调整的模型中，接受PSA检测的可能性显著较低。
这些发现表明，所有男性，尤其是非裔美国男性和西班牙裔男性，在做出前列腺癌筛查决策之前，若能了解自己患前列腺癌的具体风险，可能会从中受益。
