Factors associated to the use of Digital Rectal Exam (DRE) and the Prostate Specific Antigen test (PSA) for men over 60 in Puerto Rico

Prostate cancer is the most common type and leading cause of cancer deaths among men in Puerto Rico. More than 65.0% of prostate cancer cases are diagnosed after 65 years of age, when symptomatic and at an advanced stage. Although not considered as standards of practice, the tests to detect prostate cancer are the Digital Rectal Exam (DRE) and the Prostate Specific Antigen test (PSA). This study aims to identify factors associated to the use of the DRE and the PSA in a representative sample of men over 60 years during 2002-2003. A secondary data analysis of the cross-sectional survey called Puerto Rican Elderly: Health Conditions (PREHCO) Wave I was done. The total sample (n= 1,346) included men aged 60 years or more that have not reported been ever diagnosed with any type of cancer. Utilization was defined as using DRE and/or PSA during last year. Use of DRE and/or PSA was reported by 58.5%. Results from the logistic regression analysis suggest that being married (OR=2.2; 95%CI 1.30-3.70), declaring high school or more (OR=1.79; 95%CI 1.34-2.41), and stating a high monthly individual income (OR=1.97; 95%CI 1.37-2.8) are associated with the use of DRE and/or PSA. Visiting a doctor at least once a year (OR=6.94; 95%CI 4.86-9.91) significantly increases the probability of use of these screening tests. Findings evidence the need for health promotion efforts beyond the medical setting. Further studies are needed to address the use of each test separately, and to identify potential barriers for using secondary prevention strategies.