Prostate cancer incidence rates after removal of incidentally detected cases among lds and non-lds during the era of prostate-specific antigen screening

PURPOSE: To explore whether the relatively large prostate-specific antigen (PSA) induced peak in prostate cancer incidence rates in Utah differed between members of the Church of Jesus Christ of Latter-day Saints (LDS or Mormons), who comprise about 70% of the stateʹs population, and non-LDS METHODS: Analysis is based on 12,108 histologically confirmed cases among men ages 50 years and older with local- or regional-staged disease identified through the Utah Cancer Registry. Incidental prostate cancer cases detected through transurethral resection of the prostate were removed from the rate calculations to provide a clearer indication of the influence of PSA screening on the rates. Rates were age-adjusted to the 2000 US standard population and expressed per 100,000. RESULTS: The percentage increase in rates during the rapid and widespread adoption of PSA screening within the population (1989–92) was more pronounced among LDS than non-LDS, 296.9% vs. 250.0%. Rates were also higher among LDS than non-LDS, more so during the initial years of PSA screening: 199.0 vs. 124.1 in 1985–88, 444.8 vs. 302.0 in 1989–92, 483.2 vs. 362.1 in 1993–96, and 589.7 vs. 464.5 in 1997–99. CONCLUSION: These results indicate that LDS more readily adopted PSA screening than their non-LDS counterparts. This observation is consistent with results from the 1996 Utah Health Status Survey and other factors that we discuss.