An examination of variations in the uptake of prostate cancer screening within and between the countries of the EU-27

Health Policy. 2012 Dec;108(2-3):268-76. doi: 10.1016/j.healthpol.2012.08.014. Epub 2012 Sep 6.


Objectives: Prostate specific antigen (PSA) testing as a part of a prostate cancer control strategy is the subject of much debate. This paper examines variations in the uptake of PSA testing across Europe and the role of individual and contextual variables in explaining this variation.

Methods: Data were taken from Eurobarometer 66.2 "Health in the European Union" 2006 on self-reported uptake of screening. Data related to men across the EU-27 and Croatia, aged 40 and over (N=6986). A logistic regression analysis examines the role of individual characteristics across and within the countries.

Results: A range of individual characteristics were found to be statistically significant predictors of uptake including education, marital status, and smoking status. Socio-economic status (SES) was also a statistically significant predictor of the likelihood of screening. Variation across countries in uptake was evident; importantly a significant role was accorded primary care in explaining variation in uptake.

Conclusion: Uptake of PSA testing varies considerably within and across European countries. Differences within states relate to the characteristics of individuals offered tests and differences between states, to the system of primary care in operation. Given the significant welfare losses implicit in the evident variations the role of primary care warrants further investigation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Early Detection of Cancer / statistics & numerical data*
  • Educational Status
  • Europe / epidemiology
  • European Union / statistics & numerical data*
  • Humans
  • Logistic Models
  • Male
  • Marital Status
  • Middle Aged
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / epidemiology
  • Smoking / epidemiology
  • Socioeconomic Factors


  • Prostate-Specific Antigen