Socio-demographic and economic profile of preventive examinations for detection of prostate cancer in a population-based study in Campinas, São Paulo, Brazil
In Brazil, it is recommended that the decision to conduct the Prostate-Specific Antigen (PSA) and digital rectal examinations is taken between doctor and patient, individually. However little is known about the profile of men who undergo these procedures, through population-based studies. The aim of this paper is to describe the profile of the examinations PSA and digital rectal examination, according to the socioeconomic characteristics of men living in Campinas, São Paulo, Brazil.
METHODS:
A population-based study, in which the data are derived from health survey conducted in 2008, in Campinas (ISACamp/2008). Was included a sample of 796 men aged 40 or over, representative of the male population of the municipality in this age group. The dependent variables were "performing the PSA test at least once in life" and "performing rectal exam sometime in life". The independent variables were: age, race/color, religion, education, income and ownership of health insurance. The prevalence ratios and confidence intervals were estimated at 95% by means of Poisson regression.
RESULTS:
The prevalence of PSA was 57.3% (95%CI:50.1-64.2), while the rectal exam was 40.3% (95%CI:34.5-46.4) and 42.2% (95%CI:31.9-53.2) and 38.7% (95%CI:27.9-50.8) of these examinations, respectively, performed by the Public Health System. Positive associations were observed between PSA and performing more advanced age, white (PR:1.37; 95%CI:1.09-1.72), with higher income and who have health insurance (PR:1.46; 95%CI:1.21-1.76). Concerning to the touch exam, only age and possession of a health plan (PR:1.52; 95%CI:1.19-1.94) remained positively associated, after adjustment for age and education.
CONCLUSIONS:
It is observed that there is inequality in the realization of preventive examinations, with greater prevalence among those with health insurance and have higher income, in the case of PSA testing. In addition, non-white men have less access to these procedures and these inequalities need to be recognized to make the most equitable access to the male population.