Prostate examination among adult and elderly subjects in southern Brazil: a cross-sectional population-based study

ABSTRACT BACKGROUND: Population-wide screening for prostate cancer remains a controversial topic, given the need for an individualized approach to patients regarding the risks and benefits of prostate-specific antigen testing and digital rectal examination. OBJECTIVE: The aim of this study was to investigate the prevalence of, and factors associated with, prostate examination among men aged 45 or older. DESIGN AND SETTING: Cross-sectional population-based study developed in the city of Rio Grande (RS), Brazil. METHODS: The outcome of interest was a history of prostate examination (prostate-specific antigen testing or digital rectal examination). The following independent variables were analyzed: age group, skin color, marital status, schooling, economic level, leisure-time physical activity, smoking habits, excessive alcohol consumption, overweight, health insurance, visits to the doctor during the preceding year, hypertension and diabetes. After a two-stage sampling process, the final sample consisted of 281 male individuals. RESULTS: The prevalence of a history of prostate-specific antigen testing or digital rectal examination was 68.3% (95% confidence interval (CI): 62.2 to 74.5). The highest prevalence rates were observed among men aged 70 years or older (88%) and the lowest among smokers (36%). The following characteristics were found to be associated with the outcome: advanced age; marital status other than single; more schooling and higher economic status; practicing physical activity; non-smoking habits; overweight; having health insurance; and having visited a doctor during the preceding year. CONCLUSION: Approximately two thirds of the study population had been screened for prostate examination, mostly older individuals, with higher socioeconomic status and a healthier lifestyle.

背景：鉴于需针对前列腺特异性抗原检测（prostate-specific antigen testing）与直肠指检（digital rectal examination）的风险与获益为患者制定个体化诊疗方案，全人群前列腺癌筛查仍颇具争议。
研究目的：本研究旨在探究45岁及以上男性前列腺检查的现况及其相关影响因素。
研究设计与研究现场：本研究为在巴西南里奥格兰德州（RS）里奥格兰德市开展的基于人群的横断面研究。
研究方法：本研究的结局指标为前列腺检查史（即曾接受前列腺特异性抗原检测或直肠指检）。本次分析纳入的自变量包括：年龄分组、肤色、婚姻状况、受教育程度、经济水平、闲暇时间体力活动情况、吸烟习惯、过量饮酒情况、超重状态、医疗保险覆盖情况、前一年度就诊次数，以及高血压与糖尿病患病史。经两阶段抽样后，最终纳入281名男性作为研究样本。
研究结果：本研究中，曾接受前列腺特异性抗原检测或直肠指检的人群占比为68.3%（95%置信区间（CI）：62.2~74.5）。其中，70岁及以上男性的现患率最高（88%），吸烟者的现患率最低（36%）。研究发现以下特征与该结局指标显著相关：高龄、非未婚婚姻状况、较高受教育程度与经济水平、规律体力活动、非吸烟状态、超重、拥有医疗保险，以及前一年度曾就诊。
研究结论：本研究约三分之二的研究对象曾接受前列腺癌筛查，且以高龄、较高社会经济地位及健康生活方式的人群为主。