Institute for Health, Social and Community Research, Shaw University, Raleigh, NC 27601, USA.
Public Health Rep. 2011 Mar-Apr;126(2):228-39. doi: 10.1177/003335491112600214.
This study examined prostate-specific antigen (PSA) test use among men and identified sociodemographic and health-related characteristics associated with its use over time.
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).
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.
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.
本研究调查了男性进行前列腺特异性抗原（PSA）检测的情况，并确定了与 PSA 检测随时间推移而使用相关的社会人口学和健康相关特征。
国家健康访谈调查收集了 2000 年和 2005 年 16058 名年龄≥40 岁男性进行 PSA 检测的信息。我们研究了两个结果：（1）最近（两年内）进行了筛查性 PSA 检测，（2）过去五年内进行了三次或更多次 PSA 检测（表示频繁使用）。
在未调整模型中，未婚男性和已婚男性的婚姻状况、前列腺癌家族史以及过去一年中看过医生的情况随时间发生了变化。在调整模型中，过去一年中患有慢性病的单身、从未结婚的男性最近进行 PSA 筛查的比例有所增加，但对于患有慢性病的男性则有所减少。有前列腺癌家族史、患有慢性病和过去一年看过医生的男性频繁进行 PSA 检测的比例增加。最近 PSA 检测使用率较高的显著相关因素包括年龄较大、已婚、为黑种人/西班牙裔；受教育程度和收入较高、有医疗保险、有常规医疗服务点；以及共病率较高。
主要组织对前列腺癌筛查的疗效存在分歧；然而，年龄≥40 岁的男性仍在继续使用 PSA 检测。最近的筛查和频繁的检测在研究期间均表现出变异性，这可能对正在进行的随机临床试验产生影响，这些临床试验有望阐明使用 PSA 检测早期发现前列腺癌是否能提高生存率。
