Hamadan University of Medical Sciences Journal of Education and Community Health 2820-896X 13 1 2026 03 31 Determinants of Prostate Cancer Screening in Western Iran: Evidence from the Health Action Process Approach 17 24 10.34172/jech.4755 EN Mehdi Mirzaei-Alavijeh https://orcid.org/0000-0003-3695-6971 Sohrab Ashayeri Mehdi Moradinazar Abdollah Saadatfar Mahshad Taherpour Farzad Jalilian https://orcid.org/0000-0002-5923-7016 Journal Article 10.34172/jech.4755 2025 07 10 2026 02 25 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.