Prostate-Specific Antigen Screening in Smokers: A Comprehensive Analysis Using a National Behavioral Survey

Area of Science:

• Urology
• Public Health
• Oncology

Background:

• Cigarette smoking is linked to aggressive prostate cancer and higher mortality.
• Smokers are reportedly less likely to participate in prostate-specific antigen (PSA) screening.
• Understanding this disparity is crucial for improving cancer outcomes.

Purpose of the Study:

• To investigate the association between smoking status and guideline-concordant PSA screening.
• To determine if current smokers are less likely to undergo recommended PSA screening compared to never smokers.

Main Methods:

• Cross-sectional analysis of 58,996 men aged 55-69 from the 2018 Behavioral Risk Factor Surveillance System survey.
• Used complex weighted multivariable Poisson regression to calculate adjusted prevalence and risk differences.
• Examined data on cigarette smoking and PSA screening participation.

Main Results:

• Overall PSA screening prevalence was 39%.
• Current smokers had a significantly lower screening rate (27%) compared to never smokers (42%).
• The adjusted relative risk for PSA screening was 0.81 for current smokers versus never smokers (P < .01).

Conclusions:

• Current smokers are significantly less likely to undergo recommended PSA screening.
• Former smokers showed similar screening rates to never smokers.
• Interventions to boost screening in current smokers may improve prostate cancer diagnosis and outcomes.