Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia.
Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
Sci Rep. 2018 Mar 9;8(1):4261. doi: 10.1038/s41598-018-22589-y.
Australia has one of the highest incidence rates of prostate cancer (PC) worldwide, due in part to widespread prostate specific antigen (PSA) testing. We aimed to identify factors associated with PSA testing in Australian men without a diagnosis of prostate cancer or prior prostate disease. Participants were men joining the 45 and Up Study in 2006-2009, aged ≥45 years at recruitment. Self-completed questionnaires were linked to cancer registrations, hospitalisations, health services data and deaths. Men with a history of PC, radical prostatectomy or a "monitoring" PSA test for prostate disease were excluded. We identified Medicare reimbursed PSA tests during 2012-2014. Multivariable logistic regression was used to estimate adjusted odds ratios (OR) for the association between having PSA tests and factors of interest. Of the 62,765 eligible men, 51.8% had at least one screening PSA test during 2012-2014. Factors strongly associated with having a PSA test included having 27+ general practitioner consultations (versus 3-9 consultations; OR = 2.00; 95%CI = 1.90-2.11), benign prostatic hyperplasia treatment (versus none; OR = 1.59(95%CI = 1.49-1.70), aged 60-69 years (versus 50-59 years; OR = 1.54; 95%CI = 1.48-1.60). These results emphasise the important role of primary care in decision making about PSA testing.
澳大利亚是世界上前列腺癌（PC）发病率最高的国家之一，部分原因是广泛开展了前列腺特异性抗原（PSA）检测。我们旨在确定与澳大利亚男性中未诊断为前列腺癌或前列腺疾病且无既往前列腺疾病史的 PSA 检测相关的因素。参与者是在 2006 年至 2009 年参加 45 岁及以上研究的男性，在招募时年龄≥45 岁。通过自我完成的问卷与癌症登记、住院、卫生服务数据和死亡情况相关联。患有前列腺癌、根治性前列腺切除术或因前列腺疾病进行“监测”PSA 检测的男性被排除在外。我们确定了在 2012 年至 2014 年期间 Medicare 报销的 PSA 检测。使用多变量逻辑回归来估计与 PSA 检测相关的因素之间的调整比值比（OR）。在 62765 名合格男性中，51.8%在 2012 年至 2014 年期间至少进行了一次筛查 PSA 检测。与进行 PSA 检测密切相关的因素包括有 27+次全科医生就诊（与 3-9 次就诊相比；OR=2.00；95%CI=1.90-2.11）、良性前列腺增生治疗（与无治疗相比；OR=1.59（95%CI=1.49-1.70）、年龄 60-69 岁（与 50-59 岁相比；OR=1.54；95%CI=1.48-1.60）。这些结果强调了初级保健在 PSA 检测决策中的重要作用。
