PURPOSE: To examine the association between prostate-specific antigen (PSA) testing, prostate cancer incidence, tumour differentiation and mortality according to socioeconomic status.
MATERIALS & METHODS: Participants were 96,484 men aged between 40 and 99 years of age registered with a general practitioner in the Tayside region of Scotland, UK, between 1st January 2003 and 31st December 2008, without pre-existing prostate cancer. We conducted a retrospective cohort analysis using anonymised health data including biochemistry data for PSA tests, Scottish Index of Multiple Deprivation (SIMD), cancer registry dataset and General Register Office for Scotland (GROS) death records. Main outcome measures were use of PSA testing, prostate cancer incidence and death.
RESULTS: Men in the most affluent SIMD quintile had a greater chance of having a PSA test (OR = 1.48, 95% CI 1.40 to 1.57, p< 0.001) and prostate cancer (OR = 1.48, 95% CI 1.15 to 1.91, p= 0.002) when compared to men in the most deprived quintile adjusting for age. There was no association between SIMD quintile and prostate cancer deaths.
CONCLUSION: Increased affluence was associated with higher likelihood of having a PSA test and a higher incidence of prostate cancer. However there were no observed differences by social class of the likelihood of having a positive PSA test or prostate cancer related death.
Morgan RM, Steele RJ, Nabi G, McCowan C. Are you the author?
Division of Population Health Sciences, Medical Research Institute, University of Dundee, Dundee, DD2 4BF.
Reference: J Urol. 2013 Apr 19. pii: S0022-5347(13)04094-9.