Patterns of prostate-specific antigen (PSA) testing in Australian men: the influence of family history

Abstract

OBJECTIVE • To describe how a family history of prostate cancer infl uences men ’ s prostate cancer testing behaviours, information support preferences, and motives for testing. SUBJECTS AND METHODS • Men with a fi rst-degree family history (239 men) and a comparison sample from the general population of Queensland, Australia (289) aged 40 – 65 years, and no prior history of cancer. • Cross-sectional, retrospective survey assessing: prevalence of prostate-specifi c antigen (PSA) testing and digital rectal examination (DRE); discussion of prostate cancer risks and benefi ts with a physician; prostate cancer information needs and preferences; motivations for testing. RESULTS • Men with a family history were more likely to report: having ever had a PSA test (odds ratio [ OR ] 4.98; 95% confi dence interval [ CI ] 3.16 – 7.85), more PSA tests in their lifetimes ( b 1.04; SE 0.40; 95% CI 0.26 – 1.82); to have had a DRE (OR 2.23; 95% CI 1.54 – 3.23); to have spoken to a doctor about prostate cancer (OR 3.72; 95% CI 2.30 – 6.02); and to have instigated these discussions (OR 1.74; 95%CI 1.13 – 2.70). • Most men from both groups did not recall any discussion of the ‘ cons ’ of prostate cancer testing with a doctor. • Men with a family history reported a greater desire for information about prostate cancer prevention than did men without a family history. CONCLUSIONS • Men with a family history are more concerned about getting prostate cancer and are tested more often; however, information needs, discussions about prostate cancer, and motivations for testing are similar to those of all men. • There appears to be a disparity between public health approaches that promote informed decision-making and what is happening in practice.