Perception of susceptibility to prostate cancer and screening behaviour - insights from a case-control study [abstract]

ABSTRACT

OBJECTIVE: The aim of this study was to assess the perception of Jamaican men regarding their susceptibility to prostate cancer and to determine how this perception is associated with their decision to attend for screening of this condition. METHODS: A case-control study was conducted among 200 men between the ages of 40 and 75 years attending three health-related clinics in Kingston, Jamaica. A case was defined as any male who had a digital rectal examination or prostate specific antigen (PSA) within the last two years as a check for prostate cancer. Controls were men who did not have any of these screening tests. Factors affecting decision to attend for screening for prostate cancer were assessed through a structured interview. Specifically, participants were asked whether they perceived themselves at risk for prostate cancer. In-depth discussions were done to obtain additional insights about screening. RESULTS: The majority of screeners (70 percent) perceived themselves as being at risk of getting prostate cancer compared to 45 percent of non-screeners. Men who perceived themselves as being at risk were more likely to attend for screening than were men who did not perceive or were unsure about their risk Odds Ratio (OR) (2.85, 95 percent) Confidence Interval (CI) (1.59,3.02). There was no significant association between age and perception of risk (p> 0.05). Men felt that screening for prostate cancer was not given the level of promotion which cancers of women was given. Men who were screened were also likely to have had screening recommended by a physician (un-adjusted OR 44, 95 percent CI 17.9,108. CONCLUSIONS: Consistent with a construct of the health belief model of behaviour change, perception of susceptibility to prostate cancer appears to influence screening behaviour among men in this study. Well-designed cancer screening promotion with due consideration to screening barriers, and physician's advice are likely cues to getting screened. (AU)