Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China.
Am J Mens Health. 2021 May-Jun;15(3):15579883211026515. doi: 10.1177/15579883211026515.
To investigate the nonlinear relationship between age and the likelihood of undergoing prostate-specific antigen (PSA) testing, and the difference of factors influencing the test likelihood among subjects aged 40-54, 55-69, and ≥70 years.
Data were extracted from the 2018 Behavioral Risk Factor Surveillance System, with the primary outcome defined as receipt of a PSA test within the previous 12 months. Restricted cubic splines were used to assess the relationship between age and the likelihood of undergoing PSA testing. Backward conditional logistic regression analyses were used to identify the predictors of undergoing PSA testing among subjects aged 40-54, 55-69, and ≥70 years.
Finally, 92,177 people were identified. The likelihood of PSA testing increased up to around 71 years old and then decreased rapidly for higher ages, showing a clear nonlinear inverted U-shaped relationship with age ( < .001). Insurance status, shared decision-making, whether a recommendation for PSA testing had been accepted, income level, smoking status, and age were the common predictors of testing in the three age groups. However, the predictors differed somewhat among the three groups: being overweight or obese was only positively associated with increased testing among people aged 40-54 and ≥70 years, being retired only greatly impacted the test likelihood among those aged 40-54 years, and the general health status, marital status, and race affected people aged ≥55 years.
The factors influencing PSA screening differ with age, which should be fully considered when screening different target age groups.
探讨年龄与前列腺特异性抗原（PSA）检测可能性之间的非线性关系，以及 40-54 岁、55-69 岁和≥70 岁人群中影响检测可能性的因素差异。
从 2018 年行为风险因素监测系统中提取数据，主要结局定义为在过去 12 个月内接受 PSA 检测。使用限制三次样条评估年龄与接受 PSA 检测可能性之间的关系。使用向后条件逻辑回归分析确定 40-54 岁、55-69 岁和≥70 岁人群中进行 PSA 检测的预测因素。
最终纳入 92177 人。PSA 检测的可能性在 71 岁左右之前增加，然后随着年龄的增长迅速下降，与年龄之间呈现出明显的非线性倒 U 型关系（<0.001）。保险状况、共同决策、是否接受 PSA 检测建议、收入水平、吸烟状况和年龄是三个年龄组检测的共同预测因素。然而，预测因素在三个组之间存在一定差异：超重或肥胖仅与 40-54 岁和≥70 岁人群的检测增加呈正相关，退休仅对 40-54 岁人群的检测可能性有重大影响，一般健康状况、婚姻状况和种族影响≥55 岁人群。
影响 PSA 筛查的因素随年龄而变化，在筛查不同目标年龄组时应充分考虑这些因素。
