Association of sociodemographic factors and prostate-specific antigen (PSA) testing

Objectives: There are conflicting recommendations regarding the use of prostate specific antigen (PSA) as a screening test. Integral to this debate is an understanding of who is currently being tested. The purpose of this study was to provide a detailed account of PSA testing practices in a major Canadian city (Calgary, Alberta) and to identify variables that may affect access to the PSA test. Design and methods: PSA test counts were retrieved from Calgary Laboratory Services' Laboratory Information System from January 1, 2011 to December 31, 2011. A total of 75,914 individual PSA tests were included in our analysis. The frequency of PSA testing was plotted onto a dissemination area map of Calgary using ArcGIS software. Associations with sociodemographic variables were tested using Poisson regression. Results: The median PSA value was 0.93 μg/L and the median age at collection was 58 years. Forty-three percent of men aged 60–69 received a PSA test. Visible minority status ‘Black’ (P = 0.0002) and Métis status (P = 0.0075) were associated with lower PSA testing frequencies, while median household income (P =< 0.0001) and university education (P =< 0.0001) were associated with higher PSA testing frequencies. Conclusion: There are areas in Calgary which are significantly over or under tested relative to the mean. The amount of PSA testing in men <50 years of age is increasing, which is contrary to PSA testing guidelines