Association between Literacy, Compliance with Prostate Cancer Screening, and Cancer Aggressiveness: Results from a Brazilian Screening Study
Int. braz. j. urol
;
39(3): 328-334, May/June/2013. tab
Artigo
em Inglês
| LILACS
| ID: lil-680090
ABSTRACT
Purpose Little is known about the effects of literacy levels on prostate cancer screening. This study evaluates the association between literacy, compliance with screening, and biopsy findings in a large Brazilian screening study. Materials and Methods We analyzed 17,571 men screened for PCa with digital rectal examination (DRE) and total and free prostate-specific antigen (PSA) from January 2004 to December 2007. Of those, 17,558 men had information regarding literate status. Full urological evaluation in a specialized cancer center was recommended in the case of a) suspicious DRE, b) PSA > 4.0 ng/mL, or c) PSA 2.5-3.9 ng/mL and free/total PSA (f/tPSA) ratio < 15%. Transrectal ultrasound guided prostate biopsy (14 cores) was performed upon confirmation of these findings after the patient's consent. Patients' compliance with screening recommendations and biopsy results were evaluated according to literacy levels. Results an abnormal PSA, a suspicious DRE, or both were present in 73.2%, 19.7%, and 7.1% of those men who underwent biopsy, respectively. PCa was diagnosed in 652 men (3.7%). Previous PSAs or DREs were less common among illiterate men (p < 0.0001). Additionally, illiterate men were less prone to attend to further evaluations due to an abnormal PSA or DRE (p < 0.0001). PSA levels > 10 mg/mL (p = 0.03), clinical stage > T2a (p = 0.005), and biopsy Gleason > 7 (p = 0.02) were more common among illiterate men. Conclusions In a screened population, literacy levels were associated with prior PCa evaluations and with compliance with screening protocols. Illiterate men were at higher risk of being diagnosed with more advanced and aggressive PCa. .
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Neoplasias da Próstata
/
Programas de Rastreamento
/
Letramento em Saúde
Tipo de estudo:
Estudo diagnóstico
/
Estudo de etiologia
/
Guia de Prática Clínica
/
Estudo prognóstico
/
Fatores de risco
/
Estudo de rastreamento
Limite:
Idoso
/
Aged80
/
Humanos
/
Masculino
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Inglês
Revista:
Int. braz. j. urol
Assunto da revista:
Urologia
Ano de publicação:
2013
Tipo de documento:
Artigo
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