TY - JOUR
T1 - Prostate cancer screening practices in the Republic of Ireland
T2 - The determinants of uptake
AU - Burns, Richeal
AU - Walsh, Brendan
AU - Sharp, Linda
AU - O'Neill, Ciaran
PY - 2012/10
Y1 - 2012/10
N2 - Objectives: The objectives of this paper are to analyse the determinants of prostate cancer screening uptake in the Republic of Ireland and to compare the role of non-need factors in uptake of screening among those in and outside the age range recommended as cost-effective for screening according to the European Randomised Study of Screening for Prostate Cancer (ERSPC). Methods: The investigation combined a logistic regression analysis of uptake, with an estimation of incomerelated concentration indices and decomposition of the indices using data collected as part of the Survey of Lifestyle and Nutrition (SLAN) 2007. Comparisons were made across groups differentiated by age in terms of the expected value of the prostate cancer screening. Results: Uptake of prostate screening in men 40 years and over in the preceding 12 months was approximately 24%. Uptake was higher among those in age groups that are perceived to receive most benefit from a Prostate Specific Antigen (PSA) test based on the findings of the ERSPC trial. Screening is highest in those with highest socioeconomic status and educational attainment, and who also hold private insurance cover. The largest socioeconomic inequality is observed for men over 70 years of age (0.2298). The smallest inequality was observed for those aged 55-69 (0.1573). Decomposition of the concentration indices shows that possession of private insurance is the largest determinant of inequality among those aged 55-69 (36%) and remains a significant determinant for those aged 40-54 (26%) and those aged 70 and over (17%). Conclusions: There are high levels of prostate cancer screening uptake and significant income-related inequality in uptake in the Republic of Ireland. Given that the merits of prostate cancer screening overall and across different age groups are the subject of debate, the high levels of screening and income-related inequalities in uptake warrant closer attention and identification of potential policy responses.
AB - Objectives: The objectives of this paper are to analyse the determinants of prostate cancer screening uptake in the Republic of Ireland and to compare the role of non-need factors in uptake of screening among those in and outside the age range recommended as cost-effective for screening according to the European Randomised Study of Screening for Prostate Cancer (ERSPC). Methods: The investigation combined a logistic regression analysis of uptake, with an estimation of incomerelated concentration indices and decomposition of the indices using data collected as part of the Survey of Lifestyle and Nutrition (SLAN) 2007. Comparisons were made across groups differentiated by age in terms of the expected value of the prostate cancer screening. Results: Uptake of prostate screening in men 40 years and over in the preceding 12 months was approximately 24%. Uptake was higher among those in age groups that are perceived to receive most benefit from a Prostate Specific Antigen (PSA) test based on the findings of the ERSPC trial. Screening is highest in those with highest socioeconomic status and educational attainment, and who also hold private insurance cover. The largest socioeconomic inequality is observed for men over 70 years of age (0.2298). The smallest inequality was observed for those aged 55-69 (0.1573). Decomposition of the concentration indices shows that possession of private insurance is the largest determinant of inequality among those aged 55-69 (36%) and remains a significant determinant for those aged 40-54 (26%) and those aged 70 and over (17%). Conclusions: There are high levels of prostate cancer screening uptake and significant income-related inequality in uptake in the Republic of Ireland. Given that the merits of prostate cancer screening overall and across different age groups are the subject of debate, the high levels of screening and income-related inequalities in uptake warrant closer attention and identification of potential policy responses.
UR - http://www.scopus.com/inward/record.url?scp=84868152281&partnerID=8YFLogxK
U2 - 10.1258/jhsrp.2012.011105
DO - 10.1258/jhsrp.2012.011105
M3 - Article
C2 - 22734084
AN - SCOPUS:84868152281
SN - 1355-8196
VL - 17
SP - 206
EP - 211
JO - Journal of Health Services Research and Policy
JF - Journal of Health Services Research and Policy
IS - 4
ER -
