Prostate Cancer Screening: Do I or Don't I Participate? Identifying Predictors of Sustained Participation in Screening Programs
Creators: name: Smith, Roxanne
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2003

description: Background: Prostate cancer is the most common cancer in American men and is now the second leading cause of cancer death in men, exceeded only by lung cancer. It is estimated that in 2003, approximately 220,900 new cases and 28,900 prostate cancer related deaths will occur in the United States. The natural history of prostate cancer in not very well understood, although three main risk factors have been identified; age, African American race and family history. Survival in men with prostate cancer is related to many factors, one of the most important being extension of the tumor beyond the prostate capsule at the time of diagnosis. Therefore, a screening program for prostate cancer should ideally identify those men with more aggressive tumors that have not spread beyond the prostate capsule. One of the most controversial topics of discussion in prostate cancer has been regarding the efficacy of screening. The goal of screening is to detect disease early enough that intervention can be applied so as to reduce mortality, however this has not been proven in regards to the modalities used for prostate cancer screening. Despite the variations in recommendations for screening, some clinicians and researchers believe there is benefit to screening at risk men, particularly African Americans and those with a family history of prostate cancer. However, many men in these high-risk categories, for a variety of reasons, do not participate in prostate cancer screening. Men who have been identified as least likely to participate in prostate cancer screenings are African American, 50-59 years of age, and those with low SES. Predictors of participation in health promoting behaviors such as cancer screening that have been documented in the literature include demographics and perceived benefits. Demographics include age, race and socioeconomic status. Perceived benefits are described as beliefs about the effectiveness of the recommended action in reducing the health threat. The purpose of this work is to identify factors associated with sustained participation in free prostate cancer screening programs among high risk men. Methods: This is a case-control study of participants in a free prostate cancer screening program database. The men volunteered for screening at the annual free screening program at least one year during the study period from 1998-2001. Demographic data was collected from all screening participants and entered into a database. The participants were also asked to include the most important reason they chose to participate in a free prostate cancer screening program. Analysis of the demographic data includes identification of predictors of men who are non-sustainers, and how they compare to sustainers. Non-sustainers are identified as men who participated in screening one year, but did not participate in subsequent years. Results: There were 1024 participants in the free prostate cancer screening program. Thirty-six percent were identified as sustainers. Whites were more like than African Americans to be sustainers, however this was not significant. Those with some college education or more were more likely to participate in the free screening program however when compared to those with higher levels of education, all other groups were more likely to be sustainers; though only high school graduates were significantly different. Employment status, having a regular physician or having a close acquaintance with prostate cancer does not significantly influence sustained participation in the free screening program. The most important reasons reported for participation the screening program were convenience and cost. Conclusions: Demographic cannot be used as predictors for participation in a free prostate cancer screening program.