Abstract
BACKGROUND: Early detection through screening is crucial for improving treatment outcomes and reducing disease burden. . This study investigates the predictors of previous prostate cancer screening among Saudi men attending primary healthcare centers (PHCs) in Riyadh, Saudi Arabia. METHODS: A cross-sectional study was conducted from March to July 2023, involving 6,177 men attending 48 PHCs in Riyadh, selected via multistage cluster sampling. Unadjusted and adjusted logistic regression analyses were performed to identify significant predictors of screening, with statistical significance set at p < 0.05. RESULTS: A total of 6,177 men participated in the study. Age distribution was 31% under 50, 48.4% aged 50-75, 20.5% 75+ years . Only 1.5% of participants reported having undergone previous prostate cancer screening. crude proportions of screening were 0.9%, 1.7%, and 1.3% for the <50, 50 - 75, and ≥75 age groups, respectively. In adjusted analysis, age 50-75 years (AOR: 3.07, 95% CI: 1.73-5.46), unemployment (AOR: 3.69, 95% CI: 2.33-5.85), health insurance coverage (AOR: 2.98, 95% CI: 1.93-4.61), smoking (AOR: 4.52, 95% CI: 2.73-7.49), and history of heart disease (AOR: 3.04, 95% CI: 1.44-6.42) were significant predictors of previous prostate cancer screening. CONCLUSION: The extremely low prevalence of previous prostate cancer screening in this population underscores urgent need to improve access to PSA testing. Employment status, insurance coverage, smoking, and history of heart disease were significant predictors of screening uptake. These findings highlight need for both targeted and general interventions and support development of a national strategy for PSA testing among asymptomatic men in Saudi Arabia.