Association of sociodemographic factors and prostate-specific antigen (PSA) testing

Clin Biochem. 2014 Nov;47(16-17):164-9. doi: 10.1016/j.clinbiochem.2014.08.006. Epub 2014 Aug 14.


Objectives: There are conflicting recommendations regarding the use of prostate specific antigen (PSA) as a screening test. Integral to this debate is an understanding of who is currently being tested. The purpose of this study was to provide a detailed account of PSA testing practices in a major Canadian city (Calgary, Alberta) and to identify variables that may affect access to the PSA test.

Design and methods: PSA test counts were retrieved from Calgary Laboratory Services' Laboratory Information System from January 1, 2011 to December 31, 2011. A total of 75,914 individual PSA tests were included in our analysis. The frequency of PSA testing was plotted onto a dissemination area map of Calgary using ArcGIS software. Associations with sociodemographic variables were tested using Poisson regression.

Results: The median PSA value was 0.93 μg/L and the median age at collection was 58 years. Forty-three percent of men aged 60-69 received a PSA test. Visible minority status 'Black' (P=0.0002) and Métis status (P=0.0075) were associated with lower PSA testing frequencies, while median household income (P=<0.0001) and university education (P=<0.0001) were associated with higher PSA testing frequencies.

Conclusion: There are areas in Calgary which are significantly over or under tested relative to the mean. The amount of PSA testing in men <50 years of age is increasing, which is contrary to PSA testing guidelines.

Keywords: Hot spot analysis maps; PSA; Prostate-specific antigen testing; Sociodemographic variables.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Canada
  • Female
  • Humans
  • Male
  • Mass Screening / statistics & numerical data*
  • Middle Aged
  • Prostate-Specific Antigen*
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / diagnosis
  • Socioeconomic Factors


  • Prostate-Specific Antigen