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

PREVENTIVE MEDICINE

卷:82

Article

Guessous, Idris^1,2,3  Cullati, Stephane¹  Fedewa, Stacey A.^2,4  Burton-Jeangros, Claudine⁵  Courvoisier, Delphine S.⁶  Manor, Orly⁷  Bouchardy, Christine⁸ 

[1] Univ Hosp Geneva, Dept Community Med Primary Care & Emergency Med, Unit Populat Epidemiol, Geneva, Switzerland

[2] Emory Univ, Dept Epidemiol, Atlanta, GA 30322 USA

[3] Univ Lausanne Hosp, Inst Social & Prevent Med, Div Chron Dis, Lausanne, Switzerland

[4] Amer Canc Soc, Atlanta, GA 30329 USA

[5] Univ Geneva, Dept Sociol, Geneva, Switzerland

[6] Univ Hosp Geneva, Div Qual Care, Geneva, Switzerland

[7] Hebrew Univ Jerusalem Hadassah Hosp & Med Sch, Sch Publ Hlth & Community Med, Jerusalem, Israel

[8] Univ Geneva, Geneva Canc Registry, Global Hlth Inst, Geneva, Switzerland

关键词: PSA;    Trends;    Socioeconomic status;    Disparities;    Switzerland;   

DOI  :  10.1016/j.ypmed.2015.11.009

来源: Elsevier

【 摘 要 】

Background. 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. Methods. We used multivariable Poisson regression to estimate prevalence ratios (PR) and 95% Confidence Intervals (CI) adjusting for demographics, health status, and use of healthcare. Results. 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 < 0.05). Income, education, and occupational class were independently associated with PCa screening. PCa screening within the last two years was greater in men with the highest (>$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. Conclusions. 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. (C) 2015 Elsevier Inc. All rights reserved.

【 授权许可】

Free