Health Risk Behaviors and Prostate Specific Antigen Awareness Among Men in California

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Abstract
Differences in prostate-specific antigen (PSA) awareness may contribute to differences in frequency of PSA testing. We investigated the association of health risk behaviors, including smoking, physical inactivity, obesity, and excessive alcohol consumption with awareness of the PSA test among California men at risk for prostate cancer. Using California Health Interview Survey (CHIS) 2003 data, a population-based random-digit-dial telephone survey, records of 7,297 men aged 50 years and older without a prior history of prostate cancer were identified. The outcome was self-reported awareness of the PSA test. The main independent variables were smoking status, level of physical activity, body mass index (BMI), and alcohol consumption. Prevalence, odds ratios (OR) and 95% confidence intervals (CI) for PSA awareness were calculated using SUDAAN to account for the complex sampling design. The overall prevalence of PSA awareness was 73.0%. After controlling for potential confounders, the odds of being aware of the PSA test was lower among current smokers (OR= 0.53; 95% CI =0.41-0.68 vs. never smoked), physically inactive (OR=0.77; 95% CI=0.63-0.93 vs. physically active) and obese men (OR=0.77; 95% CI= 0.62-0.95 vs. normal weight). Health risk behaviors are associated with lower PSA awareness. Our findings suggest opportunities for focused health education interventions and quality improvement programs tailored to men who engage in unhealthy behaviors to improve their PSA test awareness.