Abstract
Introduction: Prostate cancer (PCa) is the leading malignancy among Iranian men, with high morbidity often resulting from delayed diagnosis. Early detection through prostate-specific antigen (PSA) screening can significantly improve treatment outcomes. The present study aimed to identify the predictors of PSA screening using the Health Action Process Approach (HAPA).
Methods: This cross-sectional study was conducted among 600 men aged 50–69 years without a history of PCa, selected through multistage cluster sampling from health centers in Kermanshah, western Iran. Data were collected between March and May 2023 using a structured researchermade questionnaire based on the HAPA. The questionnaire was reviewed by experts for content validity and pilot-tested for reliability. Crude and adjusted logistic regression analyses were performed to identify predictors of PSA screening.
Results: Based on the results, 7.7% of the participants (46 out of 600) had undergone PSA screening at least once. In the adjusted logistic regression model, academic education (AOR=3.65, 95% CI: 1.09–12.15, P=0.035), family history of PCa (AOR=14.36, 95% CI: 5.83–35.32, P<0.001), task self-efficacy (AOR=1.20, 95% CI: 1.00–1.43, P=0.041), and coping planning (AOR=1.34, 95% CI: 1.06–1.69, P=0.014) were identified as independent predictors of PSA screening uptake.
Conclusion: Academic education, family history of prostate cancer, task self-efficacy, and coping planning were key predictors of PSA screening. Brief theory-driven interventions should be developed to target high-risk and lower-education groups to improve screening and early detection.