Educational level and first-time PSA testing in general practice

Caroline Sophie Lerhmann-Lerche; Signe Benzon Larsen; Ingelise Andersen; Lau Caspar Thygesen; Klaus Kaae Andersen; Anne Katrine Duun-Henriksen; Christoffer Johansen; Martin Andreas Roder; Klaus Brasso; Susanne Oksbjerg Dalton

doi:10.1080/21681805.2019.1681503

Educational level and first-time PSA testing in general practice

Caroline Sophie Lerhmann-Lerche, Signe Benzon Larsen, Ingelise Andersen, Lau Caspar Thygesen, Klaus Kaae Andersen, Anne Katrine Duun-Henriksen, Christoffer Johansen, Martin Andreas Roder, Klaus Brasso, Susanne Oksbjerg Dalton

Abstract

Introduction: Different patterns in the use of prostate-specific antigen (PSA) testing might explain socioeconomic differences in prostate cancer incidence and mortality. We examined the association between socioeconomic position, measured as education and first-time PSA testing in general practice. Material and Methods: A population-based cohort study of men aged 45–79 years without prior prostate cancer diagnosis living in the Capital Region of Denmark between 2000 and 2014. Information on socioeconomic indicators (education, income, cohabitation status and work market affiliation), prostate cancer diagnoses, and vital status were obtained from national registries. Date of first PSA test was obtained from the Copenhagen Primary Care Laboratory database. Temporal trends of PSA testing were calculated as annual age-standardised incidence rates and the association was examined by a multivariable Cox proportional hazards model. Results: The cohort consists of 431,997 men of which 105,476 (24%) had a first-time PSA test in the study period. Men with longer education, higher income, living with a partner, and employed had higher rates of PSA testing. For men with short education, the rate of PSA test was 28.3 tests per 1000 person-years compared to 31.2 tests among men with long education. The fully adjusted hazard ratio for a first PSA test among men with short education was 0.87 (95% CI, 0.85–0.89) compared to men with long education. Conclusion: The association between education and first-time PSA testing indicates socioeconomic disparities in health care utilisation, which could explain part of the observed socioeconomic difference in prostate cancer incidence and mortality.

Original language	English
Journal	Scandinavian Journal of Urology
ISSN	2168-1805
DOIs	https://doi.org/10.1080/21681805.2019.1681503
Publication status	Published - 3 Sept 2019

Keywords

Socioeconomic position
education
prostate-specific antigen
primary health care
prostatic neoplasm

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1080/21681805.2019.1681503

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@article{c51139c1b565415fa8338a6224cbc90d,

title = "Educational level and first-time PSA testing in general practice",

abstract = "Introduction: Different patterns in the use of prostate-specific antigen (PSA) testing might explain socioeconomic differences in prostate cancer incidence and mortality. We examined the association between socioeconomic position, measured as education and first-time PSA testing in general practice. Material and Methods: A population-based cohort study of men aged 45–79 years without prior prostate cancer diagnosis living in the Capital Region of Denmark between 2000 and 2014. Information on socioeconomic indicators (education, income, cohabitation status and work market affiliation), prostate cancer diagnoses, and vital status were obtained from national registries. Date of first PSA test was obtained from the Copenhagen Primary Care Laboratory database. Temporal trends of PSA testing were calculated as annual age-standardised incidence rates and the association was examined by a multivariable Cox proportional hazards model. Results: The cohort consists of 431,997 men of which 105,476 (24%) had a first-time PSA test in the study period. Men with longer education, higher income, living with a partner, and employed had higher rates of PSA testing. For men with short education, the rate of PSA test was 28.3 tests per 1000 person-years compared to 31.2 tests among men with long education. The fully adjusted hazard ratio for a first PSA test among men with short education was 0.87 (95% CI, 0.85–0.89) compared to men with long education. Conclusion: The association between education and first-time PSA testing indicates socioeconomic disparities in health care utilisation, which could explain part of the observed socioeconomic difference in prostate cancer incidence and mortality.",

keywords = "Socioeconomic position, education, prostate-specific antigen, primary health care, prostatic neoplasm",

author = "Lerhmann-Lerche, {Caroline Sophie} and Larsen, {Signe Benzon} and Ingelise Andersen and Thygesen, {Lau Caspar} and Andersen, {Klaus Kaae} and Duun-Henriksen, {Anne Katrine} and Christoffer Johansen and Roder, {Martin Andreas} and Klaus Brasso and Dalton, {Susanne Oksbjerg}",

year = "2019",

month = sep,

day = "3",

doi = "10.1080/21681805.2019.1681503",

language = "English",

journal = "Scandinavian Journal of Urology",

issn = "2168-1805",

publisher = "Taylor & Francis",

}

TY - JOUR

T1 - Educational level and first-time PSA testing in general practice

AU - Lerhmann-Lerche, Caroline Sophie

AU - Larsen, Signe Benzon

AU - Andersen, Ingelise

AU - Thygesen, Lau Caspar

AU - Andersen, Klaus Kaae

AU - Duun-Henriksen, Anne Katrine

AU - Johansen, Christoffer

AU - Roder, Martin Andreas

AU - Brasso, Klaus

AU - Dalton, Susanne Oksbjerg

PY - 2019/9/3

Y1 - 2019/9/3

N2 - Introduction: Different patterns in the use of prostate-specific antigen (PSA) testing might explain socioeconomic differences in prostate cancer incidence and mortality. We examined the association between socioeconomic position, measured as education and first-time PSA testing in general practice. Material and Methods: A population-based cohort study of men aged 45–79 years without prior prostate cancer diagnosis living in the Capital Region of Denmark between 2000 and 2014. Information on socioeconomic indicators (education, income, cohabitation status and work market affiliation), prostate cancer diagnoses, and vital status were obtained from national registries. Date of first PSA test was obtained from the Copenhagen Primary Care Laboratory database. Temporal trends of PSA testing were calculated as annual age-standardised incidence rates and the association was examined by a multivariable Cox proportional hazards model. Results: The cohort consists of 431,997 men of which 105,476 (24%) had a first-time PSA test in the study period. Men with longer education, higher income, living with a partner, and employed had higher rates of PSA testing. For men with short education, the rate of PSA test was 28.3 tests per 1000 person-years compared to 31.2 tests among men with long education. The fully adjusted hazard ratio for a first PSA test among men with short education was 0.87 (95% CI, 0.85–0.89) compared to men with long education. Conclusion: The association between education and first-time PSA testing indicates socioeconomic disparities in health care utilisation, which could explain part of the observed socioeconomic difference in prostate cancer incidence and mortality.

AB - Introduction: Different patterns in the use of prostate-specific antigen (PSA) testing might explain socioeconomic differences in prostate cancer incidence and mortality. We examined the association between socioeconomic position, measured as education and first-time PSA testing in general practice. Material and Methods: A population-based cohort study of men aged 45–79 years without prior prostate cancer diagnosis living in the Capital Region of Denmark between 2000 and 2014. Information on socioeconomic indicators (education, income, cohabitation status and work market affiliation), prostate cancer diagnoses, and vital status were obtained from national registries. Date of first PSA test was obtained from the Copenhagen Primary Care Laboratory database. Temporal trends of PSA testing were calculated as annual age-standardised incidence rates and the association was examined by a multivariable Cox proportional hazards model. Results: The cohort consists of 431,997 men of which 105,476 (24%) had a first-time PSA test in the study period. Men with longer education, higher income, living with a partner, and employed had higher rates of PSA testing. For men with short education, the rate of PSA test was 28.3 tests per 1000 person-years compared to 31.2 tests among men with long education. The fully adjusted hazard ratio for a first PSA test among men with short education was 0.87 (95% CI, 0.85–0.89) compared to men with long education. Conclusion: The association between education and first-time PSA testing indicates socioeconomic disparities in health care utilisation, which could explain part of the observed socioeconomic difference in prostate cancer incidence and mortality.

KW - Socioeconomic position

KW - education

KW - prostate-specific antigen

KW - primary health care

KW - prostatic neoplasm

U2 - 10.1080/21681805.2019.1681503

DO - 10.1080/21681805.2019.1681503

M3 - Journal article

C2 - 31663414

SN - 2168-1805

JO - Scandinavian Journal of Urology

JF - Scandinavian Journal of Urology

ER -

Educational level and first-time PSA testing in general practice

Abstract

Keywords

UN SDGs

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