There is a big divide in male cancer testing rates
Published 02/09/2014 | 02:30
Irishmen who have poorer psychological health are less likely to have a prostate screening test, according to a new study.
The PSA test is not a specific examination for prostate cancer, but it looks for raised levels of a protein in the blood which may be a sign of the disease.
The rate of PSA testing in Ireland is high and the number of these exams continues to rise with the majority carried out by a GP.
The analysis of 3,628 men aged 50 and over found that nearly seven in 10 have had the test, but men with undiagnosed depression and those with frailer health were significantly less likely to have the test.
Men who suffered from anxiety, smokers and those eligible for free GP care were also less likely to be screened.
The reverse was the case for men with a long-term illness and who visited the GP more often, had cholesterol tests and received the flu vaccine, the results revealed.
The study, which was carried out by researchers at the National Cancer Registry and Trinity College, is published in BMC Family Practice.
Around 3,124 men are diagnosed with prostate cancer annually in Ireland and 500 die of the disease.
The PSA test remains controversial because it is seen as unreliable.
It can suggest the presence of prostate cancer where there is none, leaving some men having unnecessary and potentially painful biopsies.
The protein increases in men as they age and more than 65pc of men who have a raised PSA level will not have the cancer.
However, the higher the PSA level is, the more likely it is that there is disease and that the prostate gland may need further investigation.
The Irish Cancer Society says that PSA may be raised for non-cancerous reasons too.
For this reason, an abnormal reading is often followed by a second test, usually six weeks later.
The NCR and Trinity College researchers concluded that men who are not having the test may also be losing out on other routine cancer screening.
"The impact of poor psychological health on the likelihood of men having a PSA test has received little attention," they reported.
They suggested that GPs may be less likely to initiate discussions about PSA testing and prostate cancer with depressed men for fear of exacerbating their condition.
"Our findings concur with previous work which observed lower rates of breast, cervical and colo-rectal (bowel) cancer screening among people with depression despite increased use of primary care services."
The study found out that even though men with a medical card have free GP visits, they are also less likely to have the PSA test.
"This is consistent with income-related inequality in uptake of PSA testing observed in Ireland," the authors added.
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