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Men's estimates of prostate cancer risk and self-reported rates of screening
J E Ward1, A M Hughes, G H Hirst
1Central Sydney Area Health Service, Needs Assessment & Health Outcomes Unit, Sydney, NSW. jward@nah.rpa.cs.nsw.gov.au
Objective:
To determine rates of prostate cancer screening and predictors of men's participation in this screening in the light of national recommendations against prostate cancer screening
Design:
Community-based study (computer-assisted telephone survey).
Setting:
Central Sydney Area Health Service.
Participants:
Randomly selected men aged 40-80 years.
Results:
340 men participated (65% response rate). While the true lifetime (0-74 years) risk of developing or dying from prostate cancer is reported to be one in 18 (6%) and one in 65 (1.5%), respectively, 37% of respondents thought that at least one in five men (20%) would develop prostate cancer before the age of 75 years and 11% that one in five (20%) would die from it. Twenty-two per cent of men aged 50 years or over had been screened for prostate cancer within the previous 12 months. Ever worrying about prostate cancer and bothersome urinary symptoms independently predicted the probability of screening within the previous year. Sociodemographic characteristics such as age, occupation and country of birth were not associated with screening.
Conclusions:
Public health initiatives to discourage prostate cancer screening should focus particularly on men with bothersome urinary symptoms and those who worry about prostate cancer. Accurate information about the low risks of dying from prostate cancer needs to be communicated, and the speculative nature of current evidence in support of screening as a means of reducing this risk should be emphasised.