PSA testing and receipt of curative treatment in elderly Japanese men with prostate cancer: a population-based study

Abstract Objective This study aimed to evaluate whether regular prostate-specific antigen (PSA) testing is associated with the receipt of curative treatment for prostate cancer among men in Japan and to identify associated factors. Methods A retrospective analysis was conducted using the claims data from the National Health Insurance and Late-Stage Elderly Health Care System in Saga Prefecture between March 2014 and March 2022. Patients were categorized into PSA testing (≥ 1 test ≥ 6 months before treatment) and non-PSA testing groups. Curative treatment was defined as either a radical prostatectomy or carbon-ion radiotherapy. Multivariable logistic regression was used to identify the factors associated with curative treatment. Results Among 2,200 patients, 737 (33.5%) underwent PSA testing, and 708 (32.2%) received curative treatment. Patients who underwent PSA testing were older and more likely to participate in Specific Health Checkups. The proportion receiving curative treatment was higher in the PSA testing group (36.4% vs. 30.1%, p < 0.001). Age (OR = 0.85), PSA testing (OR = 1.53), and participation in Specific Health Checkups, which do not include PSA testing, were independently associated with curative treatment (OR = 1.64). Conclusions PSA testing was associated with a higher likelihood of receiving curative treatment for prostate cancer. Participation in Specific Health Checkups may reflect a population more engaged in preventive healthcare or with greater access to screening opportunities.