Prostate cancer screening in Switzerland: 20-year trends and socioeconomic disparities.

Despite important controversy in its efficacy, prostate cancer (PCa) screening has become widespread. Important socioeconomic screening disparities have been reported. However, trends in PCa screening and social disparities have not been investigated in Switzerland, a high risk country for PCa.

We used data from five waves (from 1992-2012) of the population-based Swiss Health Interview Survey to evaluate trends in PCa screening and its association with socioeconomic indicators. We used multivariable Poisson regression to estimate prevalence ratios (PR) and 95% Confidence Intervals (CI) adjusting for demographics, health status, and use of healthcare. The study included 12,034 men aged ≥50 years (mean age: 63. 9). Between 1992 and 2012, ever use of PCa screening increased from 55. 3% to 70. 0% and its use within the last two years from 32. 6% to 42. 4% (p-value$6,000/month) vs. lowest income (≤$2,000) (46. 5% vs. 38. 7% in 2012, PR for overall period =1. 29, 95%CI: 1. 13-1. 48). These socioeconomic disparities did not significantly change over time. This study shows that about half of Swiss men had performed at least one PCa screening. Men belonging to high socioeconomic status are clearly more frequently screened than those less favored. Given the uncertainty of the usefulness of PCa screening, men, including those with high socioeconomic status, should be clearly informed about benefits and harms of PCa screening, in particular, the adverse effect of over-diagnosis and of associated over-treatment.

Preventive medicine. 2015 Nov 12 [Epub ahead of print]

Idris Guessous, Stéphane Cullati, Stacey A Fedewa, Claudine Burton-Jeangros, Delphine S Courvoisier, Orly Manor, Christine Bouchardy

Unit of population epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland; Emory University, Department of Epidemiology, Atlanta, GA, USA; Division of chronic diseases, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland. Unit of population epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland. , Emory University, Department of Epidemiology, Atlanta, GA, USA; American Cancer Society, Atlanta, GA ,USA. , Department of sociology, University of Geneva, Geneva, Switzerland. , Division of quality of care, University Hospitals of Geneva, Geneva, Switzerland. , School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel. , Geneva Cancer Registry, Global Health Institute, University of Geneva, Geneva, Switzerland.

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