ASSOCIATIONS OF DEMOGRAPHIC AND HEALTH-RELATED CHARACTERISTICS WITH PROSTATE-CANCER SCREENING IN WASHINGTON-STATE

This report describes associations of demographic and health-related c haracteristics with use of prostate cancer screening. Data are from a random-digit dial survey of Washington State residents. Analyses are r estricted to men ages 40-79 years (n = 332) and examine both digital r ectal examination (DRE) and blood tests for prostate-specific antigen (PSA) in the previous 2 Sears. Results are adjusted to be representati ve of the state's population. In 1996, 53.6% of men received either DR E, 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 demograp hic characteristics, the relative odds for any prostate cancer screeni ng were 5.5 for ages 60-79 versus 40-49 years, 2.4 for 16+ versus less than or equal to 12 gears of education, and 4.0 for 2+ versus no phys ician visits in the previous 2 years (all P < 0,05), Characteristics g enerally associated with good health, including regular exercise and l ow fat and high fruit and vegetable intakes, were also significantly a ssociated with prostate cancer screening, In conclusion, in 1996, appr oximately one-half of the men in Washington State over age 40 years ha d 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 c ancer screening increased markedly with age. Because PSA screening inc reases detection of prostate cancer, epidemiological studies of health behavior and cancer risk must carefully control for screening history to avoid detection bias.