The Incidence of Prostate-Specific Antigen Test in a Country With a Limited Social Perception of Prostate Cancer 2006-2016: Disparities Manifested by Residential Area

Abstract

Purpose: To trace the incidence of serum prostate-specific antigen (PSA) tests by the residential areas of Korea, where social awareness on prostate cancer (PCa) is limited due to the absence of a public screening.

Materials and Methods: From Korean national health insurance data, the number of men older than 40 years who performed PSA testing without PCa or before the enrollment on the national registry during 2006–2016 was identified, then its association with the incidence of PCa were analyzed by a residential area categorized into metropolitan, urban, and rural area.

Results: PSA testing was performed more in the metropolitan area in 2006–2008, but performed the most prevalently in the rural area since 2010. Among the 17 administrative districts, the most PSA-tested district was Jeollabuk-do (9.36%) in 2016, which was Seoul (2.85%) in 2006. The mean repetition number of PSA tests during 11 years of the study period was highest among the inhabitant of Seoul (3.25 times, p<0.0001), followed by Gwangju (2.98 times), another metropolitan city. The mean repetition number of PSA tests during the study decade was in the order of metropolitan area (2.97 times), rural area (2.83 times), and urban area (2.75 times, p<0.0001). In every year, however, the incidence of PCa was the highest in a rural area, where had the oldest mean age.

Conclusions: Despite a recent increase of PSA screening and diagnosis of PCa especially in the rural area, the opportunity of repeated testing was presented more to the inhabitant of a metropolitan area.