SOCIODEMOGRAPHIC AND HEALTH STATUS CHARACTERISTICS ASSOCIATED WITH PROSTATE CANCER SCREENING IN A NATIONAL COHORT OF MIDDLE-AGED MALE VETERANS SETH A. EISEN, BRIAN WATERMAN, CELETTE SUGG SKINNER, JEFFREY F. SCHERRER, JAMES C. ROMEIS, KATHLEEN BUCHOLZ, ANDREW HEATH, JACK GOLDBERG, MICHAEL J. LYONS, MING T. TSUANG, AND WILLIAM R. TRUE ABSTRACT Objectives. To characterize variables associated with obtaining prostate cancer screening in a nonclinical, nationally distributed, middle-aged male population. Methods. Telephone interviews were administered to 2652 individual members of the Vietnam Era Twin Registry in 1992 and 1995. Dependent variables were self-report measures of having had a digital rectal examination (DRE) and/or a prostate-specific antigen (PSA) test in the past 5 years. Independent variables were current measures of age, household income, education, race, insurance, source of care, and lifetime measures of physical condition, psychiatric illness, and alcohol and nicotine dependence. Results. Thirty-five percent of the sample reported having had a PSA and DRE within the past 5 years. Prevalence of obtaining either a PSA or DRE varied with age, income, education, and race. Subjects with a regular source of care, a regular physician, and health insurance reported higher rates of having had a DRE or PSA and DRE. Persons with a physical or psychiatric illness reported more screening. A multiple regression model revealed that having a regular source of care, having a regular physician, physical illness, psychiatric illness, minority status, higher income, and age predicted having had some form of screening. Conclusions. A substantial portion of middle-aged men have had both a PSA and DRE performed at least once in the preceding 5 years. It may be possible to further improve prostate cancer screening participation by directing educational programs at men who are not in contact with the healthcare system. If the PSA and DRE screening guidelines that are finally adopted discourage screening among low-risk men younger than age 50, educational programs that emphasize age screening criteria may be warranted. UROLOGY 53: 516–522, 1999. © 1999, Elsevier Science Inc. All rights reserved. This study was supported by the Department of Veterans Affairs Health Services Research and Development Service (Cooperative Studies Program #992), NIH grants AA10339 and DA04604, and NIH training grants MH17104 and DA07261. Partial support was provided by the NIDA (Bethesda, Maryland) grant 1 RO1 DAO 4604-01; NIAAA grant 1 RO1 AA10339-01, Great Lakes Veterans Affairs Health Services Research and Development Program, Ann Arbor, Michigan, LIP 41-065; Public Health Service grants MH- 37685 and MH-31302; and NIDA training grant DAO72261-01 awarded to Washington University, St. Louis, Missouri. From the Research Service and Medical Service, St. Louis Vet- erans Affairs Medical Center; Department of Internal Medicine, Division of General Medical Sciences, and Mallinckrodt Institute, Washington University School of Medicine; School of Public Health, St. Louis University; Departments of Psychiatry, and Psy- chology and Genetics, Washington University School of Medi- cine, St. Louis, Missouri; Department of Veterans Affairs, Health Services Research and Development, Cooperative Studies in Health Services, Hines and Epidemiology Program, University of Illinois School of Public Health, Chicago, Illinois; Department of Psychology, Boston University, Boston; Harvard Medical School Department of Psychiatry at the Brockton/West Roxbury Veter- ans Affairs, Brockton and Harvard Institute of Psychiatric Epide- miology and Genetics; and Harvard Medical School Department of Psychiatry at Massachusetts Mental Health Center and Depart- ment of Epidemiology, Harvard School of Public Health, Boston, Massachusetts Reprint requests: Seth A. Eisen, M.D., M.Sc., Research Service (151-JC), Veterans Affairs Medical Center-St. Louis, 915 North Grand Boulevard, St. Louis, MO 63106 Submitted: July 28, 1998, accepted (with revisions): September 3, 1998 ADULT UROLOGY © 1999, ELSEVIER SCIENCE INC. 0090-4295/99/$20.00 516 ALL RIGHTS RESERVED PII S0090-4295(98)00545-7