Predictors of PSA Screening Among Men Over 40 Years of Age Who Had Ever Heard about PSA

Purpose: The purpose of this study was to investigate social and behavioral factors associated with prostate-specific antigen (PSA) screening in men in California, United States, who were over 40 years of age and had ever heard about PSA screening. Materials and Methods: This survey was administered as a random-digit-dialing telephone survey to produce reliable estimates of medium-sized counties. It surveyed 42,000 households and interviewed 58,407 people randomly. It considered socioeconomic status and health behavior as affecting PSA screening. Access to health care was measured as having regular health care access. The main outcome measure was self-report of ever having undergone PSA screening at least once in the respondent's lifetime. Results: Of 8,864 respondents, 82.2% were White, 7.7% were Latin, 4.2% were African American, and 5.9% were Asian. The respondents' mean age was 60.13 years. Age was the significant factor for PSA screening. Respondents aged 50-59 years were 3.5 times as likely to have undergone PSA screening as were those aged 40-49 years (OR=3.49, p$\leq$0.001). Race was not statistically significant after considering other factors. People who had never married had statistically significantly lower screening than did people who were married (OR=0.71, p=0.001). Poverty levels were statistically significant in both the unadjusted and the adjusted analysis. People who had no regular health care access were much less likely to have undergone PSA screening than were people who had regular health care access (OR=0.22, p=0.001). Conclusions: The likelihood of PSA screening was positively associated with increased age, marital status (married), higher socioeconomic status (higher federal poverty level and higher educational attainment), and health care access. However, there was no statistically significant association of PSA screening with race, employment, exercise, smoking, or drinking status.