Abstract
BACKGROUND: Prostate cancer is an increasing health concern among aging male populations in China, yet evidence on their screening behaviors remains limited. This study aimed to examine the knowledge, attitudes, and practices (KAP) of middle-aged and elderly males regarding prostate cancer and its early screening. METHODS: This cross-sectional study was conducted at the urologic surgery clinic of the First People's Hospital of Changzhou from September to November 2023.The KAP scores were evaluated using a self-designed questionnaire. RESULTS: A total of 616 responses were collected, with 518 valid questionnaires included in the analysis. The mean age of participants was 59.47±14.84 years. The mean scores for KAP were 7.58±5.67 (possible range, 0-20), 25.27±2.27 (possible range, 7-35), and 26.11±3.94 (possible range, 7-35), respectively. Multivariate logistic regression showed that knowledge score [odds ratio (OR) =1.066; 95% confidence interval (CI): 1.010-1.124], currently smoking (OR =1.972; 95% CI: 1.087-3.578), and with previous prostate cancer early screening (OR =0.235; 95% CI: 0.142-0.391) were independently associated with proactive practice. Mediation analysis indicated that knowledge directly affected both attitude and practice, with no significant indirect effect on practice (all P<0.05). CONCLUSIONS: Middle-aged and elderly men demonstrate insufficient knowledge but exhibit positive attitudes and proactive practices regarding prostate cancer. This study provides critical insights into the KAP of middle-aged and elderly males regarding prostate cancer screening, an under-researched area in public health.