Sociodemographic and health status characteristics associated with prostate cancer screening in a national cohort of middle-aged male veterans

Objectives. To characterize variables associated with obtaining prostate ca ncer screening in a nonclinical, nationally distributed, middle-aged male p opulation. Methods, Telephone interviews were administered to 2652 individual members of the Vietnam Era Twin Registry in 1992 and 1995. Dependent variables were self-report measures of having had a digital rectal examination (DRE) and/ or a prostate-specific antigen (PSA) test in the past 5 years. Independent variables were current measures of age, household income, education, race, insurance, source of care, and lifetime measures of physical condition, psy chiatric illness, and alcohol and nicotine dependence. Results. Thirty-five percent of the sample reported having had a PSA and DR E within the past 5 years. Prevalence of obtaining either a PSA or DRE vari ed with age, income, education, and race. Subjects with a regular source of care, a regular physician, and health insurance reported higher rates of h aving had a DRE or PSA and DRE. Persons with a physical or psychiatric illn ess reported more screening. A multiple regression model revealed that havi ng a regular source of care, having a regular physician, physical illness, psychiatric illness, minority status, higher income, and age predicted havi ng had some form of screening. Conclusions. A substantial portion of middle-aged men have had both a PSA a nd DRE performed at least once in the preceding 5 years. It may be possible to further improve prostate cancer screening participation by directing ed ucational programs at men who are not in contact with the healthcare system . If the PSA and DRE screening guidelines that are finally adopted discoura ge screening among low-risk men younger than age 50, educational programs t hat emphasize age screening criteria may be warranted. (C) 1999, Elsevier S cience Inc. All rights reserved.