Prostate-Specific Antigen Screening in Smokers: A Comprehensive Analysis Using a National Behavioral Survey

No AccessUrology PracticeClinical Research2 Apr 2024Prostate-Specific Antigen Screening in Smokers: A Comprehensive Analysis Using a National Behavioral SurveyThis article is commented on by the following: Editorial Comment I. Mitchell Harmatz, Khalid Y. Alkhatib, Morgan Leff, José I. Nolazco, Katharine F. Michel, Michelle Slinger, Nathaniel McLauchlan, Brian D. Cortese, Daniel S. Roberson, Benjamin Schurhamer, Daniel J. Lee, S. Bruce Malkowicz, Quoc-Dien Trinh, Trinity J. Bivalacqua, Thomas J. Guzzo, and Phillip M. Pierorazio I. Mitchell HarmatzI. Mitchell Harmatz https: //orcid. org/0000-0003-0313-5325, Khalid Y. AlkhatibKhalid Y. Alkhatib Corresponding Author: Khalid Y. Alkhatib, MD, MMSc, Division of Urology, University of Pennsylvania, 51 N 39th St, Suite 300 MOB, Penn Presbyterian Medical Center, Philadelphia, PA 19104 (email protected), (email protected) https: //orcid. org/0000-0002-6008-0503, Morgan LeffMorgan Leff https: //orcid. org/0009-0002-2453-4181, José I. NolazcoJosé I. Nolazco https: //orcid. org/0000-0002-0239-6542, Katharine F. MichelKatharine F. Michel https: //orcid. org/0000-0002-8499-7869, Michelle SlingerMichelle Slinger, Nathaniel McLauchlanNathaniel McLauchlan https: //orcid. org/0000-0001-6749-5288, Brian D. CorteseBrian D. Cortese https: //orcid. org/0000-0002-8523-8151, Daniel S. RobersonDaniel S. Roberson https: //orcid. org/0000-0002-6817-853X, Benjamin SchurhamerBenjamin Schurhamer, Daniel J. LeeDaniel J. Lee, S. Bruce MalkowiczS. Bruce Malkowicz, Quoc-Dien TrinhQuoc-Dien Trinh https: //orcid. org/0000-0003-3857-9276, Trinity J. BivalacquaTrinity J. Bivalacqua https: //orcid. org/0000-0002-0870-4366, Thomas J. GuzzoThomas J. Guzzo, and Phillip M. PierorazioPhillip M. Pierorazio https: //orcid. org/0000-0003-0766-9981 View All Author Informationhttps: //doi. org/10. 1097/UPJ. 0000000000000553AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookLinked InTwitterEmail Abstract Introduction: Cigarette smoking is associated with higher-risk prostate cancer at the time of diagnosis and increased overall and prostate cancer‒specific mortality. Previous studies indicate smokers are less likely to undergo PSA screening. Herein we investigate the association between smoking and PSA screening using a nationally representative US survey. We hypothesize that smokers are less likely to undergo guideline-concordant PSA screening. Methods: We performed a cross-sectional analysis of men aged 55 to 69 who responded to the cigarette smoking and PSA screening questions of the 2018 Behavioral Risk Factor Surveillance System survey. Adjusted prevalence and adjusted risk differences were calculated using complex weighted multivariable Poisson regression modeling. Results: We identified 58, 996 individuals who qualified for analysis. PSA screening prevalence was 39% (95% CI: 39%-40%) nationally, 42% (95% CI: 41%-44%) for never smokers, 42% (95% CI: 39%-40%) for former smokers, and 27% (95% CI: 25%-29%) for current smokers, including 27% (95% CI: 24%-29%) for daily smokers and 29% (95% CI: 24%-33%) for nondaily smokers. Compared to never smokers, the adjusted relative risk for undergoing PSA screening was 0. 81 for current smokers (95% CI: 0. 75-0. 88, P <. 01) and 0. 99 for former smokers (95% CI: 0. 94-1. 03, P =. 53). Conclusions: Current smokers are less likely to undergo recommended PSA screening, but former smokers are screened at similar rates as never smokers. 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Funding/Support: Dr Trinh reported receiving research funding from the American Cancer Society, Pfizer Global Medical (Prostate Cancer Disparities grant 63354905), and the Department of Defense Congressionally Directed Medical Research Program (Health Disparity research award No. PC220551). Conflict of Interest Disclosures: Dr Trinh reported consulting fees from Astellas, Bayer, Intuitive Surgical, Janssen, Novartis, and Pfizer. No other disclosures were reported. Ethics Statement: This study was deemed exempt from Institutional Review Board review. Author Contributions: Conception and design: Alkhatib, Harmatz, Nolazco, Pierorazio. Data analysis and interpretation: Alkhatib, Harmatz, Pierorazio. Drafting the manuscript: Alkhatib, Harmatz, Leff, Nolazco, Michel, Slinger, McLauchlan, Cortese, Roberson, Pierorazio. Critical revision of the manuscript for scientific and factual content: Nolazco, Roberson, Lee, Schurhamer, Trinh, Malkowicz. Statistical analysis: Alkhatib, Harmatz. Supervision: Bivalacqua, Guzzo, Pierorazio. Data Availability: The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request. The results of this study were presented as an abstract at the 24th Annual Meeting of the Society of Urologic Oncology, November 28 to December 1, 2023. © 2024 by American Urological Association Education and Research, Inc. FiguresReferencesRelatedDetailsRelated articlesUrology Practice13 Mar 2024Editorial Comment Supplementary Materials Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc. Keywordscigarette smokingprostate-specific antigenprostatic neoplasmspreventive medicinesmoking cessationMetrics Author Information I. Mitchell Harmatz Co-first authors. More articles by this author Khalid Y. Alkhatib Corresponding Author: Khalid Y. Alkhatib, MD, MMSc, Division of Urology, University of Pennsylvania, 51 N 39th St, Suite 300 MOB, Penn Presbyterian Medical Center, Philadelphia, PA 19104 (email protected), (email protected) Co-first authors. More articles by this author Morgan Leff More articles by this author José I. Nolazco More articles by this author Katharine F. Michel More articles by this author Michelle Slinger More articles by this author Nathaniel McLauchlan More articles by this author Brian D. Cortese More articles by this author Daniel S. Roberson More articles by this author Benjamin Schurhamer More articles by this author Daniel J. Lee More articles by this author S. Bruce Malkowicz More articles by this author Quoc-Dien Trinh More articles by this author Trinity J. Bivalacqua More articles by this author Thomas J. Guzzo More articles by this author Phillip M. Pierorazio More articles by this author Expand All Recusal: Dr Pierorazio is an AUA publications online content editor and was recused from the editorial and peer review processes. Funding/Support: Dr Trinh reported receiving research funding from the American Cancer Society, Pfizer Global Medical (Prostate Cancer Disparities grant 63354905), and the Department of Defense Congressionally Directed Medical Research Program (Health Disparity research award No. PC220551). Conflict of Interest Disclosures: Dr Trinh reported consulting fees from Astellas, Bayer, Intuitive Surgical, Janssen, Novartis, and Pfizer. No other disclosures were reported. Ethics Statement: This study was deemed exempt from Institutional Review Board review. Author Contributions: Conception and design: Alkhatib, Harmatz, Nolazco, Pierorazio. Data analysis and interpretation: Alkhatib, Harmatz, Pierorazio. Drafting the manuscript: Alkhatib, Harmatz, Leff, Nolazco, Michel, Slinger, McLauchlan, Cortese, Roberson, Pierorazio. Critical revision of the manuscript for scientific and factual content: Nolazco, Roberson, Lee, Schurhamer, Trinh, Malkowicz. Statistical analysis: Alkhatib, Harmatz. Supervision: Bivalacqua, Guzzo, Pierorazio. Data Availability: The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request. The results of this study were presented as an abstract at the 24th Annual Meeting of the Society of Urologic Oncology, November 28 to December 1, 2023. Advertisement PDF downloadLoading. . .