Richardson Harriet, Aronson Kristan J, James Alison, McGregor Elizabeth S, Bryant Heather
Open Med. 2007 Apr 14;1(1):e3-e12.
Very few data are available on the determinants of PSA testing in Canada, and it is a matter of debate whether prostate-specific antigen (PSA) screening in asymptomatic men age 50 and older with no risk factors for prostate cancer is useful. If PSA screening is introduced into the periodic health examination, it will be important to know what factors influence its use.
The purpose of this study is to determine the factors associated with PSA testing among asymptomatic men age 50 and older participating in the Tomorrow Project in Alberta.
The Tomorrow Project is a population-based cohort study with over 11,000 participants accrued in Alberta since February 2003. Information was collected on medical history, sociodemographic factors, health status and lifestyle characteristics. This analysis includes 2136 men 50 years of age and older. The independent association between various factors and recent PSA screening is estimated using logistic regression.
Approximately 50% of of the study group had received one or more PSA tests in their lifetime. Of these, 58% were asymptomatic for prostate disease at the time of their most recent PSA test. Variables independently associated with recent PSA screening for prostate cancer in this population include older age (>/= 65 versus < 55 years: adjusted odds ratio [OR] 2.60; 95% confidence interval [CI] 1.77-3.83), higher income (>/= $80,000 versus < $20,000, OR 1.97; 95% CI 1.09-3.55), region of health care delivery, perception of health status (good versus excellent health status; OR 0.65, CI 0.43-0.96], increased number of chronic health conditions (OR 1.73, 95% CI 1.10-2.71), and history of colorectal cancer screening with fecal occult blood test (OR 2.21; 95% CI 1.73-2.83).
An increasing proportion of men in Alberta are receiving a PSA test. A number of significant predictors of having a PSA test were identified, suggesting that factors other than having a clinical indication for prostate disease can influence decisions about PSA screening.
关于加拿大前列腺特异性抗原（PSA）检测的决定因素，可获取的数据非常少，对于50岁及以上且无前列腺癌风险因素的无症状男性进行PSA筛查是否有用存在争议。如果将PSA筛查纳入定期健康检查，了解哪些因素会影响其使用将很重要。
本研究的目的是确定参与艾伯塔省明日项目的50岁及以上无症状男性中与PSA检测相关的因素。
明日项目是一项基于人群的队列研究，自2003年2月以来在艾伯塔省招募了超过11000名参与者。收集了病史、社会人口学因素、健康状况和生活方式特征等信息。该分析纳入了2136名50岁及以上的男性。使用逻辑回归估计各种因素与近期PSA筛查之间的独立关联。
研究组中约50%的男性一生中接受过一次或多次PSA检测。其中，58%在最近一次PSA检测时无前列腺疾病症状。在该人群中，与近期前列腺癌PSA筛查独立相关的变量包括年龄较大（≥65岁与＜55岁相比：调整后的优势比[OR]为2.60；95%置信区间[CI]为1.77 - 3.83）、收入较高（≥80000美元与＜20000美元相比，OR为1.97；95%CI为1.09 - 3.55）、医疗服务提供地区、对健康状况的认知（健康状况良好与极佳相比；OR为0.65，CI为0.43 - 0.96）、慢性健康状况数量增加（OR为1.73，95%CI为1.10 - 2.71）以及有粪便潜血试验进行结直肠癌筛查的病史（OR为2.21；95%CI为1.73 - 2.83）。
艾伯塔省接受PSA检测的男性比例在增加。确定了一些进行PSA检测的重要预测因素，表明除了有前列腺疾病的临床指征外，其他因素也会影响PSA筛查的决策。
