Ogunsanya Motolani E, Jiang Shan, Thach Andrew V, Bamgbade Benita A, Brown Carolyn M
Health Outcomes and Pharmacy Practice Division, The College of Pharmacy, The University of Texas at Austin, Austin, TX.
Health Outcomes and Pharmacy Practice Division, The College of Pharmacy, The University of Texas at Austin, Austin, TX.
Urol Oncol. 2016 Dec;34(12):529.e9-529.e14. doi: 10.1016/j.urolonc.2016.06.016. Epub 2016 Jul 21.
The purposes of the study were to examine the prevalence of prostate cancer screening (PCS) in the United States and to identify predictors of PCS guided by Andersen's Behavioral Model of Health Services Use (ABM).
PCS rates were analyzed in men (aged ≥40y) using 2014 data from the Behavioral Risk Factor Surveillance System. Descriptive analysis was conducted using sampling weights to determine the prevalence of PCS (i.e., had a prostate-specific antigen test). Multiple logistic regression within the framework of ABM was used to identify predictors of PCS. The ABM variables of predisposing (e.g., age), enabling (e.g., health insurance), and need (e.g., comorbidities) comprised the independent variables.
Among the 131,415 men, 62.4% (N = 82,014) reported that they had a prostate-specific antigen test in the last 2 years. Among predisposing factors, age, education, income, and employment status were significantly associated with undergoing PCS. Informed decision-making process, health care coverage, regular health care provider, and length of time since last routine checkup were significant enabling factors. Health care provider recommendation and previous cancer diagnosis were significant need factors.
Most older men in the United States had previously engaged in PCS. Several ABM variables were predictive of PCS and should be considered when developing future strategies to encourage PCS in at-risk men with the recommended life expectancies. Such strategies should also ensure that the decision to undergo PCS is an informed process between patients and their health care providers.
本研究的目的是调查美国前列腺癌筛查（PCS）的普及率，并确定以安德森卫生服务利用行为模型（ABM）为指导的PCS预测因素。
使用行为危险因素监测系统2014年的数据对年龄≥40岁的男性的PCS率进行分析。使用抽样权重进行描述性分析，以确定PCS的普及率（即进行了前列腺特异性抗原检测）。在ABM框架内使用多重逻辑回归来确定PCS的预测因素。易患因素（如年龄）、促成因素（如医疗保险）和需求因素（如合并症）的ABM变量构成自变量。
在131,415名男性中，62.4%（N = 82,014）报告称他们在过去2年中进行了前列腺特异性抗原检测。在易患因素中，年龄、教育程度、收入和就业状况与接受PCS显著相关。知情决策过程、医疗保险覆盖范围、定期的医疗保健提供者以及自上次常规检查以来的时间长度是重要的促成因素。医疗保健提供者的建议和先前的癌症诊断是重要的需求因素。
美国大多数老年男性此前都进行过PCS。几个ABM变量可预测PCS，在制定未来策略以鼓励预期寿命符合推荐标准的高危男性进行PCS时应予以考虑。此类策略还应确保接受PCS的决定是患者与其医疗保健提供者之间的知情过程。
