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Examination of prostate-specific antigen (PSA) screening in military and civilian men: analysis of the 2018 behavioral risk factor surveillance system

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Abstract

Purpose

To determine whether military men report different prostate-specific antigen (PSA) screening rates than civilian men and if shared decision-making (SDM) is associated with PSA screening.

Methods

We used data from the 2018 Behavioral Risk Factor Surveillance System and included 101,901 men (26,363 military and 75,538 civilian men) in the analysis conducted in 2021. We conducted binomial logistic regression analyses to determine covariate-adjusted associations between military status and receiving a PSA test in the last 2 years. We then added patient reports of SDM to the model. Finally, we looked at the joint effects of military status and SDM on the receipt of a PSA test in the last 2 years.

Results

Military men had 1.1 times the odds of PSA testing compared to civilian men (95% CI 1.1, 1.2) after adjusting for SDM and sociodemographic and health covariates. When examining the joint effect of military status and SDM, military and civilian men had over three times the odds of receiving a PSA test in the last 2 years if they had reported SDM (OR 3.5 and OR 3.4, respectively) compared to civilian men who did not experience SDM.

Conclusion

Military men are slightly more likely to report receiving a PSA test in the last 2 years compared to civilian men. Additionally, results show SDM plays a role in the receipt of a PSA test in both populations. These findings can serve as a foundation for tailored interventions to promote appropriate SDM for PSA screening in civilian, active duty, and veteran healthcare systems.

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Fig. 1
Fig. 2

aSDM Shared decision-making. The adjusted model controlled for the following covariates: race/ethnicity, age, employment status, marital status, urban/rural status, education, insurance status, regular provider status, self-rated general health, smoking status, and alcohol use

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Notes

  1. We recognize that some persons with prostates (e.g., transgender women and gender non-binary persons) may not identify with the label of men. Those included in this study who did indicate a gender all specified it as “male,” therefore, we will use this terminology.

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Acknowledgments

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Disclaimer

The article was prepared as part of some of the authors’ (AWS, PDR, SCK, MAM) official duties as employees of the U.S. Federal Government. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the National Cancer Institute.

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Authors and Affiliations

  1. Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA

    Susan S. Hoffman

  2. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA

    Ashley W. Smith, V. Paul Doria-Rose, Sarah C. Kobrin & Michelle A. Mollica

  3. Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC, USA

    Erin E. Kent

  4. University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA

    Erin E. Kent

Authors
  1. Susan S. Hoffman
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  2. Ashley W. Smith
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  3. Erin E. Kent
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  4. V. Paul Doria-Rose
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  5. Sarah C. Kobrin
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  6. Michelle A. Mollica
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Correspondence to Susan S. Hoffman.

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Hoffman, S.S., Smith, A.W., Kent, E.E. et al. Examination of prostate-specific antigen (PSA) screening in military and civilian men: analysis of the 2018 behavioral risk factor surveillance system. Cancer Causes Control 33, 393–402 (2022). https://doi.org/10.1007/s10552-021-01533-y

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  • DOI: https://doi.org/10.1007/s10552-021-01533-y

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