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Use of the Prostate-Specific Antigen Test among U.S. Men: Findings from the 2005 National Health Interview Survey

Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

Requests for reprints: Zahava Berkowitz, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, K-55, Atlanta, GA 30341-3717. Phone: 770-488-4881; Fax: 770-488-4639. E-mail: zab3{at}cdc.gov

Background: Although evidence that prostate cancer deaths are reduced by screening for elevated prostate-specific antigen (PSA) concentration coupled with early diagnosis and treatment is insufficient to advocate routine screening for prostate cancer, PSA testing has become more common in the past decade. We examined characteristics that might influence testing and compared test use between men ages 40 to 49 and 50 to 79 years.

Methods: We used data from 7,669 participants with no history of prostate cancer in the 2005 National Health Interview Survey.

Results: Among men reporting about PSA testing, an estimated 16% of 40- to 49-year-old men and 49% of 50- to 79-year-old men had a PSA test in the past 2 years. In multivariate analyses, among men ages 40 to 49 years, non-Hispanic Black men were more likely (P < 0.05) to have had a PSA test than non-Hispanic White men. We found no significant difference by race/ethnicity in men ages 50 to 79 years. Higher education, higher poverty threshold, usual source of medical care, family history of prostate cancer, and comorbid conditions were associated with increased PSA test use in both age groups. Additionally, men ages 50 to 79 years born in the United States, who were married, had private or military health insurance, and had been diagnosed with another cancer type were more likely to be tested.

Conclusions: Findings from the multivariate analyses indicated significantly higher PSA test use among younger non-Hispanic Black men than among non-Hispanic White men. These findings may indicate that healthcare providers are getting and conveying the message of increased risk of prostate cancer among African American men. (Cancer Epidemiol Biomarkers Prev 2008;17(3):636–44)