Patterns of prostate-specific antigen (PSA) testing in Australian men: the influence of family history

OBJECTIVE To describe how a family history of prostate cancer influences men's prostate cancer testing behaviours, information support preferences, and motives for testing. SUBJECTS AND METHODS Men with a fi rst-degree family history (239 men) and a comparison sample from the general population of Queensland, Australia (289) aged 40-65 years, and no prior history of cancer. Cross-sectional, retrospective survey assessing: prevalence of prostate-specifi c antigen (PSA) testing and digital rectal examination (DRE); discussion of prostate cancer risks and benefi ts with a physician; prostate cancer information needs and preferences; motivations for testing. RESULTS Men with a family history were more likely to report: having ever had a PSA test (odds ratio [OR] 4.98; 95% confi dence interval [CI] 3.16-7.85), more PSA tests in their lifetimes (b 1.04; SE 0.40; 95% CI 0.26-1.82); to have had a DRE (OR 2.23; 95% CI 1.54-3.23); to have spoken to a doctor about prostate cancer (OR 3.72; 95% CI 2.30-6.02); and to have instigated these discussions (OR 1.74; 95% CI 1.13-2.70). Most men from both groups did not recall any discussion of the ` cons ' of prostate cancer testing with a doctor. Men with a family history reported a greater desire for information about prostate cancer prevention than did men without a family history. CONCLUSIONS Men with a family history are more concerned about getting prostate cancer and are tested more often; however, information needs, discussions about prostate cancer, and motivations for testing are similar to those of all men. There appears to be a disparity between public health approaches that promote informed decision-making and what is happening in practice.