Merrill Ray M, Gibbons Ian S
Department of Public Health, College of Life Sciences, Brigham Young University, 2063 Life Sciences Building, Provo, UT, 84602, USA.
Sci Rep. 2024 Dec 28;14(1):31345. doi: 10.1038/s41598-024-82821-w.
The prevalence of prostate-specific antigen (PSA) testing has consistently fallen for several years. This study explored how the decreasing trend differs by selected variables and reasons for taking the PSA test. Analyses involved men, aged 40 years or older, who completed the Behavior Risk Factor Surveillance System (BRFSS) survey in even number years from 2008 through 2022. Trends in PSA testing rates within the past year declined by 46% from 2008 to 2020 and then increased 21% from 2020 to 2022. The greatest changes corresponded with the years of new USPSTF guidelines. Declining PSA testing rates occurred across the levels of all variables considered but were more pronounced in younger men and men never married, less educated, and without health care coverage. After adjusting for these variables, declining PSA testing rates did not significantly differ between racial/ethnic groups or between income groups. The level of several variables influenced the decline, as a function of perceived risk, accessibility, and desire for the test. Inconsistencies with the USPSTF's guidelines were seen in higher PSA testing in older and more educated men. The distribution of main reasons for taking the test (part of a routine exam [72%], prostate problem/cancer [12%], family history [6%], and other [10%]) remained constant. PSA testing as part of a routine exam (vs. no PSA test) increased with age and was higher in non-Hispanic Blacks, married (or cohabitating), and in men with higher education, higher income, and health care coverage. PSA testing because of a prostate problem/cancer or family history of prostate cancer according to these variables are also described in this study.
前列腺特异性抗原（PSA）检测的普及率已连续数年持续下降。本研究探讨了这一下降趋势在不同选定变量以及进行PSA检测的原因方面有何不同。分析对象为年龄在40岁及以上、在2008年至2022年偶数年份完成行为危险因素监测系统（BRFSS）调查的男性。过去一年中，PSA检测率从2008年到2020年下降了46%，然后从2020年到2022年上升了21%。最大的变化与美国预防服务工作组（USPSTF）新指南发布的年份相对应。在所有考虑的变量水平上，PSA检测率都在下降，但在年轻男性以及从未结婚、受教育程度较低且没有医疗保险的男性中更为明显。在对这些变量进行调整后，种族/族裔群体之间或收入群体之间PSA检测率的下降没有显著差异。几个变量的水平影响了下降情况，这是感知风险、可及性和检测意愿的函数。在年龄较大和受教育程度较高的男性中，PSA检测率较高，这与USPSTF的指南不一致。进行检测的主要原因（作为常规检查的一部分[72%]、前列腺问题/癌症[12%]、家族史[6%]和其他[10%]）的分布保持不变。作为常规检查一部分的PSA检测（与不进行PSA检测相比）随年龄增长而增加，在非西班牙裔黑人、已婚（或同居）以及受教育程度较高、收入较高且有医疗保险的男性中更高。本研究还描述了根据这些变量因前列腺问题/癌症或前列腺癌家族史而进行的PSA检测情况。
