Close D R, Kristal A R, Li S, Patterson R E, White E
Cancer Prevention Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA.
Cancer Epidemiol Biomarkers Prev. 1998 Jul;7(7):627-30.
This report describes associations of demographic and health-related characteristics with use of prostate cancer screening. Data are from a random-digit dial survey of Washington State residents. Analyses are restricted to men ages 40-79 years (n = 332) and examine both digital rectal examination (DRE) and blood tests for prostate-specific antigen (PSA) in the previous 2 years. Results are adjusted to be representative of the state's population. In 1996, 53.6% of men received either DRE, PSA, or both. Among those screened, 42% received DRE alone, 15% PSA alone, and 43% both PSA and DRE, and the percentages of men receiving PSA increased markedly with age (30%, ages 40-49 years; 58%, ages 50-59 years; and 77%, ages 60-79 years). After control for other demographic characteristics, the relative odds for any prostate cancer screening were 5.5 for ages 60-79 versus 40-49 years, 2.4 for 16+ versus < or = 12 years of education, and 4.0 for 2+ versus no physician visits in the previous 2 years (all P < 0.05). Characteristics generally associated with good health, including regular exercise and low fat and high fruit and vegetable intakes, were also significantly associated with prostate cancer screening. In conclusion, in 1996, approximately one-half of the men in Washington State over age 40 years had received prostate cancer screening in the previous 2 years. Few men were screened with PSA alone, and the use of PSA as part of prostate cancer screening increased markedly with age. Because PSA screening increases detection of prostate cancer, epidemiological studies of health behavior and cancer risk must carefully control for screening history to avoid detection bias.
本报告描述了人口统计学特征和健康相关特征与前列腺癌筛查使用情况之间的关联。数据来自对华盛顿州居民的随机数字拨号调查。分析仅限于40 - 79岁的男性（n = 332），并考察了过去两年内的直肠指检（DRE）和前列腺特异性抗原（PSA）血液检测情况。结果经过调整以代表该州人口。1996年，53.6%的男性接受了DRE、PSA检测或两者都接受了检测。在接受筛查的人群中，42%仅接受了DRE，15%仅接受了PSA，43%同时接受了PSA和DRE，并且接受PSA检测的男性比例随年龄显著增加（40 - 49岁为30%；50 - 59岁为58%；60 - 79岁为77%）。在控制了其他人口统计学特征后，60 - 79岁男性进行任何前列腺癌筛查的相对比值比为40 - 49岁男性的5.5倍，受教育16年及以上者相对于受教育12年及以下者为2.4倍，过去两年内看医生2次及以上者相对于未看医生者为4.0倍（所有P < 0.05）。通常与健康良好相关的特征，包括经常锻炼以及低脂肪、高水果和蔬菜摄入量，也与前列腺癌筛查显著相关。总之，1996年，华盛顿州40岁以上的男性中约有一半在过去两年内接受了前列腺癌筛查。很少有男性仅接受PSA筛查，并且将PSA作为前列腺癌筛查一部分的使用情况随年龄显著增加。由于PSA筛查增加了前列腺癌的检出率，健康行为和癌症风险的流行病学研究必须仔细控制筛查史以避免检测偏倚。
