scholarly journals Factors associated with PSA testing in men ≥ 50 years in Ireland

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
R O'Donovan ◽  
P Fitzpatrick
Keyword(s):  
Prostate Cancer ◽  
Screening Programme ◽  
Population Based ◽  
Older Age ◽  
Related Factors ◽  
Psa Test ◽  
Psa Screening ◽  
Psa Testing ◽  
Increased Risk ◽  
Health Related

Abstract Background Ireland has among the highest rates of prostate cancer in the EU, primarily due to widespread PSA screening. PSA screening is not recommended for asymptomatic men. Due to the potential for harm to the patient, and the economic and clinical repercussions for the healthcare system caused by inappropriate screening, this study aimed to investigate associations between PSA screening and sociodemographic, lifestyle, and health-related factors in men ≥50 years in Ireland. Methods A cross-sectional study was completed using data from Wave 4 of The Irish Longitudinal Study on Aging (TILDA), a nationally representative sample of community dwellers ≥ 50 years in Ireland. Participants self-reported having or not having a PSA test to screen for prostate cancer in the previous two years. Variables were entered into a multivariable logistic regression to estimate adjusted odds ratios (OR) for associations between PSA testing and the factors of interest. Results There were 2,426 male participants, with 68% reporting a PSA test in the previous two years. In adjusted analysis, older age (OR 1.78, 95%CI 1.32-2.31), third level education (OR 1.34, 95%CI 1.07-1.69) and a higher household net income (OR 2.14, 95% CI 1.52-3.02) increased the likelihood of PSA testing. Health-related factors positively associated with PSA testing screening were private health insurance (OR 1.89, 95%CI 1.52-2.35), blood pressure measurement in the previous year (OR 8.80, 95%CI 6.06-12.77) and a positive family history of cancer (OR 1.42, 95%CI 1.13-1.78). Conclusions High rates of prostate cancer screening are taking place in Ireland, despite the absence of a population-based screening programme. Men of older age, higher socioeconomic status and who demonstrate health-protective-behaviours have an increased risk of PSA screening. This subgroup of the population should be targeted to increase awareness of the potential benefits and harms of PSA testing. Key messages Rates of PSA screening remain high in Ireland, despite the absence of a population-based screening programme. Increased awareness of the potential harms and benefits of PSA screening is needed.

scholarly journals PSA testing in general practice

2012 ◽  
Vol 4 (3) ◽  
pp. 199 ◽  
Author(s):  
Fraser Hodgson ◽  
Zuzana Obertová ◽  
Charis Brown ◽  
Ross Lawrenson
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Age Groups ◽  
Psa Test ◽  
Psa Screening ◽  
Psa Testing ◽  
Asymptomatic Patients ◽  
Keywords Prostate ◽  
General Practices

INTRODUCTION: In New Zealand, prostate-specific antigen (PSA) testing has increased significantly (275 000 tests/year). Controversy exists around PSA testing as part of an unorganised screening programme. AIM: To look at the use of PSA testing in a sample of general practices and investigate the reasons GPs undertake PSA testing. METHODS: Five Waikato general practices investigated looking at PSA laboratory tests of men =40 years in 2010 compared against GP notes. Testing rates, reasons for testing, histology and referral/s were examined for different age groups. A questionnaire was sent to the GPs to determine their views on PSA testing. RESULTS: One in four men aged 40+ years had a PSA test in 2010. Of these men, 71% were asymptomatic. More than half of men tested aged 70+ years were asymptomatic. Ten percent of all PSA tests were elevated. Twenty-one of 23 prostate cancers were diagnosed following an elevated PSA test: more than 80% of these men had histories of prostate pathology or lower urinary tract symptoms. The questionnaire confirmed that GPs believe in the benefits of PSA screening and it also showed they had difficulty in providing patients with information about pros and cons of PSA testing. DISCUSSION: All GPs in this study tested asymptomatic men. GPs in this study value PSA screening and believe that it reduces mortality rates. However, although PSA tests were most frequently done on asymptomatic patients, the majority of patients subsequently diagnosed with prostate cancer had been tested because of symptoms or had previous prostate problems. KEYWORDS: Prostate specific antigen (PSA); PSA testing; screening; prostate cancer; general practitioners

scholarly journals The comparative effectiveness of mpMRI and MRI-guided biopsy vs regular biopsy in a population-based PSA testing: a modeling study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Abraham M. Getaneh ◽  
Eveline A. M. Heijnsdijk ◽  
Harry J. de Koning
Keyword(s):  
Prostate Cancer ◽  
Prostate Cancer Screening ◽  
Population Based ◽  
Cancer Death ◽  
Resonance Imaging ◽  
Psa Test ◽  
Prostate Cancer Mortality ◽  
Psa Screening ◽  
Regular Screening ◽  
Life Years

AbstractThe benefit of prostate cancer screening is counterbalanced by the risk of overdiagnosis and overtreatment. The use of a multi-parametric magnetic resonance imaging (mpMRI) test after a positive prostate-specific antigen (PSA) test followed by magnetic resonance imaging-guided biopsy (MRIGB) may reduce these harms. The aim of this study was to determine the effects of mpMRI and MRIGB vs the regular screening pathway in a population-based prostate cancer screening setting. A micro-simulation model was used to predict the effects of regular PSA screening (men with elevated PSA followed by TRUSGB) and MRI based screening (men with elevated PSA followed by mpMRI and MRIGB). We predicted reduction of overdiagnosis, harm-benefit ratio (overdiagnosis per cancer death averted), reduction in number of biopsies, detection of clinically significant cancer, prostate cancer death averted, life-years gained (LYG), and quality adjusted life years (QALYs) gained for both strategies. A univariate sensitivity analysis and threshold analysis were performed to assess uncertainty around the test sensitivity parameters used in the MRI strategy.In the MRI pathway, we predicted a 43% reduction in the risk of overdiagnosis, compared to the regular pathway. Similarly a lower harm-benefit ratio (overdiagnosis per cancer death averted) was predicted for this strategy compared to the regular screening pathway (1.0 vs 1.8 respectively). Prostate cancer mortality reduction, LY and QALYs gained were also slightly increased in the MRI pathway than the regular screening pathway. Furthermore, 30% of men with a positive PSA test could avoid a biopsy as compared to the regular screening pathway. Compared to regular PSA screening, the use of mpMRI as a triage test followed by MRIGB can substantially reduce the risk of overdiagnosis and improve the harm-benefit balance, while maximizing prostate cancer mortality reduction and QALYs gained.

scholarly journals Death of an offspring and parental risk of ischemic heart diseases: A population-based cohort study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (9) ◽  
pp. e1003790
Author(s):  
Dang Wei ◽  
Imre Janszky ◽  
Fang Fang ◽  
Hua Chen ◽  
Rickard Ljung ◽  
...  
Keyword(s):  
Heart Diseases ◽  
Population Based ◽  
Ischemic Heart ◽  
Related Factors ◽  
Individual Level ◽  
Ischemic Heart Diseases ◽  
Increased Risk ◽  
Level Information ◽  
Health Related ◽  
Rate Ratios

Background The death of a child is an extreme life event with potentially long-term health consequences. Knowledge about its association with ischemic heart diseases (IHDs) and acute myocardial infarction (AMI), however, is very limited. We investigated whether the death of an offspring is associated with the risk of IHD and AMI. Methods and findings We studied parents of live-born children recorded in the Danish (1973 to 2016) and the Swedish (1973 to 2014) Medical Birth Registers (n = 6,711,952; mean age at baseline 31 years, 53% women). We retrieved information on exposure, outcomes, and covariates by linking individual-level information from several nationwide registers. We analyzed the abovementioned associations using Poisson regression. A total of 126,522 (1.9%) parents lost at least 1 child during the study period. Bereaved parents had a higher risk of IHD and AMI than the nonbereaved [incidence rate ratios (IRRs) (95% confidence intervals (CIs)): 1.20 (1.18 to 1.23), P < 0.001 and 1.21 (1.17 to 1.25), P < 0.001, respectively]. The association was present not only in case of losses due to CVD or other natural causes, but also in case of unnatural deaths. The AMI risk was highest in the first week after the loss [IRR (95% CI): 3.67 (2.08 to 6.46), P < 0.001], but a 20% to 40% increased risk was observed throughout the whole follow-up period. Study limitations include the possibility of residual confounding by socioeconomic, lifestyle, or health-related factors and the potentially limited generalizability of our findings outside Scandinavia. Conclusions The death of an offspring was associated with an increased risk of IHD and AMI. The finding that the association was present also in case of losses due to unnatural causes, which are less likely to be confounded by cardiovascular risk factors clustering in families, suggests that stress-related mechanisms may also contribute to the observed associations.

scholarly journals Prostate Cancer Screening with PSA: Ten Years’ Experience of Population Based Early Prostate Cancer Detection Programme in Lithuania

2020 ◽  
Vol 9 (12) ◽  
pp. 3826
Author(s):  
Ausvydas Patasius ◽  
Agne Krilaviciute ◽  
Giedre Smailyte
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Cancer Detection ◽  
Detection Rate ◽  
Screening Programme ◽  
Prostate Cancer Screening ◽  
Target Population ◽  
Population Based ◽  
Cancer Detection Rate ◽  
Psa Test

The aim of this study is to report key performance estimates from the ten years of a population-based prostate cancer screening programme in Lithuania. Retrospective analysis of screening activities recorded in 2006–2015 among men aged 50–74 years was performed. We estimated screening coverage, cancer detection rate, compliance to biopsy, and positive predictive values in each screening round inside and outside the target population. In the first 10 years of screening, 16,061 prostate cancer cases were registered within the screening programme, 10,202 were observed among screened men but reported outside the screening programme, and 1455 prostate cancers were observed in a screening-naïve population. Screening cover reached up to 45.5% of the target population in the recent rounds. The proportion of prostate specific antigen (PSA) test-positive men decreased from 16.9% in 2006 to 10.7% in 2014–2015. Up to 40.0% of PSA test-positive men received a biopsy, of whom 42.0% were positive for prostate cancer. The cancer detection rate was 10.4−15.0% among PSA test-positives and 1.4–1.9% among screened individuals. Screening participants were more likely to be diagnosed with organ-confined disease as compared to non-participants. Despite the unorganized screening practices being employed and low coverage per screening round, 70% of the target population were screened at least once in the first 10 years of screening.

scholarly journals Risk-adapted approach to prostate cancer screening

2018 ◽  
Vol 14 (2) ◽  
pp. 109-121 ◽  
Author(s):  
A. A. Kirichek ◽  
L. N. Lyubchenko ◽  
V. B. Matveev
Keyword(s):  
Prostate Cancer ◽  
Early Detection ◽  
Germline Mutation ◽  
Prostate Cancer Screening ◽  
Germline Mutations ◽  
Polygenic Inheritance ◽  
Psa Screening ◽  
Psa Testing ◽  
Mutation Carriers ◽  
Brca1 Brca2

Mass prostatic specific antigen (PSA) testing (population-based PSA screening) has remained controversial, nevertheless there are men cohorts likely to benefit from PSA screening. Heritable factors contribute to 60 % risk for developing familial prostate cancer. Despite the fact that its clinical application is challenging due to polygenic inheritance, advances in new generation sequencing technologies permit identifying highly penetrant germline mutations in genes BRCA1, BRCA2, CHEK2, HOXB13 and MMR associated with tremendous increase in risk of developing the prostate cancer. Several germline mutations are associated with clinically aggressiveness of disease and shortened survival. Targeted screening that is based on family history and genomic aberrations should be the next step towards the precision medicine. Men at elevated risk should been performed for early detection are those with familiar history of prostate cancer, or BRCA1, BRCA2, CHEK2, HOXB13 and MMR pathogenic germline mutation carriers, or first line relatives diagnosed with certain types of cancer. Systematic PSA testing in 1–2 years among germline mutation carriers men beginning at age 45 years would contribute to increase in early detection of localized prostate cancer resulting in more chance of curative treatment and improve survival rates

scholarly journals Sleep Quality and Its Associated Factors among Low-Income Adults in a Rural Area of China: A Population-Based Study

2018 ◽  
Vol 15 (9) ◽  
pp. 2055 ◽  
Author(s):  
Wenwen Wu ◽  
Wenru Wang ◽  
Zhuangzhuang Dong ◽  
Yaofei Xie ◽  
Yaohua Gu ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Low Income ◽  
Rural Areas ◽  
Population Based ◽  
Poor Sleep ◽  
Chinese Adults ◽  
Poor Sleep Quality ◽  
Related Factors ◽  
Health Related ◽  
The Mean

Background: There is limited population-based research focusing on sleep quality among low-income Chinese adults in rural areas. This study aimed to assess sleep quality among low-income adults in a rural area in China and identify the association between sleep quality and sociodemographic, lifestyle and health-related factors. Methods: The study was conducted from September to November in 2017 using a cross-sectional survey questionnaire. A total of 6905 participants were recruited via multistage, stratified cluster sampling. Data were collected using the Chinese versions of Pittsburgh Sleep Quality Index and Food Frequency Questionnaire, while we also determined the sociodemographic profiles of the participants. Results: The mean age of the sample was 58.71 ± 14.50 years, with 59.7% being male, while the mean duration of daily sleep was 5.95 ± 1.31 h, with 56.7% reportedly experiencing poor sleep quality. Multiple regression analysis revealed that older age, unemployment, lower income, disability and chronic disease comorbidities were significant factors associated with an increased risk of poor sleep quality for both genders. Moreover, married and higher education level were associated with decreased risk of poor sleep quality for females, while a meat-heavy diet and illness during the past two weeks increased the risk of poor sleep quality for males. Conclusions: Sociodemographic, lifestyle and health-related factors had an impact on the frequently poor sleep quality of low-income Chinese adults in rural areas. Thus, comprehensive measures must be developed to address the modifiable predictive factors that can possibly enhance sleep quality.

LIVING AND HEALTH CONDITIONS ASSOCIATED WITH OVERWEIGHT AND OBESITY AMONG ELDERLY

2015 ◽  
pp. 1-9
Author(s):  
B.F. DO NASCIMENTO JACINTO DE SOUZA ◽  
L. MARÍN-LEON
Keyword(s):  
Chronic Diseases ◽  
Eating Behaviors ◽  
Multinomial Logistic Regression ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Overweight And Obesity ◽  
Related Factors ◽  
Cross Sectional ◽  
Increased Risk ◽  
Health Related

Background: The epidemiological and nutritional transition processes in the last decades underlie the rising trend of obesity in the elderly and is related to increased risk of chronic non-communicable diseases and decreased functional status. Objective: To analyze the association of demographic, socioeconomic, lifestyle and health-related factors with overweight and obesity in elderly. Design: Cross-sectional study. Setting: Carried out in Campinas-São Paulo, Brazil, in 2011. Participants: 452 non-institutionalized elderly (aged ≥60 years), half were users of a government-run soup kitchen and the other half were neighbors of the same sex. Results:Overweight frequency (BMI ≥25 and <30 kg/m2) was 44.5% and obesity (BMI ≥30 kg/m2) was 21.7%. In the multiple multinomial logistic regression model adjusted for sex, age group and economic class, there was greater chance of overweight among those that reported dyslipidemia; those that reported arthritis/ arthrosis/rheumatism and that once or more per week replaced supper by a snack were more likely to be obese. Elderly who did not leave home daily and reported diabetes had higher chance of overweight and obesity. Conclusions: Overweight and obesity are associated with worse living and health-related conditions, such as physical inactivity, changes in eating behaviors, and chronic diseases. Public health policies should encourage regular physical activity and healthy eating behaviors, focusing on traditional diet, through nutritional education, in order to reduce the prevalence of overweight and obesity and chronic diseases.

Comorbidity of Medical and Psychiatric Disorders in Geriatric Population

2018 ◽  
pp. 448-474
Author(s):  
Pratima Kaushik
Keyword(s):  
Health Services ◽  
Effective Treatment ◽  
Related Factors ◽  
Geriatric Population ◽  
Healthcare Facilities ◽  
Age Related ◽  
Increased Risk ◽  
Co Morbidity ◽  
The Social ◽  
Health Related

Ageing is a universal phenomenon that has not only social but also economic, political, and health-related implications. With the advancement in healthcare facilities and better availability of health services, the geriatric population is gradually increasing. But, this group is at an increased risk of developing both physical and psychological co-morbidities due to age-related factors and changes in the social circumstances. The present chapter proposes the concept and issues related to co-morbidity in the geriatric population. After discussing the issues and consequences of medical and psychiatric co-morbidities, their effective treatment regime and care/management in relation to the geriatric population are addressed.

DEFINING MEN AT INCREASED RISK OF DEVELOPING PROSTATE CANCER: EVIDENCE FROM A POPULATION-BASED SCREENING COHORT

2009 ◽  
Vol 181 (4S) ◽  
pp. 747-747 ◽  
Author(s):  
Monique J Roobol ◽  
Fritz H Schröder ◽  
Gerald L Andriole ◽  
Neil E Fleshner
Keyword(s):  
Prostate Cancer ◽  
Population Based ◽  
Increased Risk
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