Utilization of prostate cancer screening in Germany – An examination of influencing factors with special consideration of migration history

Background Prostate cancer is the most common cancer and the third leading cause of cancer-related death among men in Europe. In Germany, men aged 45 and older are eligible for annual prostate cancer screening, which includes a digital rectal examination and, optionally, a prostate-specific antigen (PSA) test. However, the effectiveness of both methods remains controversial. Socioeconomic and demographic factors, such as education, income, and age, influence participation in screening, but the impact of migration history has not been sufficiently investigated in the German context. Methods Using data from the fourth wave of the lidA cohort study comprising 4196 men, the present study examines the factors that influence participation in prostate cancer screening in Germany, with a specific focus on migration history. Results Multivariable analysis showed that first-generation migrants were 24% less likely to participate in screening (aOR: 0.76; 95%-CI: 0.59–0.98; p = 0.034), while second-generation migrants showed no significant differences compared to non-migrants (aOR: 1.04; 95%-CI: 0.78–1.38; p = 0.808). Younger birth cohorts, low education level, low income, absence of pre-existing conditions and of a partner were significantly associated with lower participation. Conclusions Whether lower participation in screening has an impact on health outcomes remains unclear. The decision to participate in prostate cancer screening should be based on individualized counseling that considers both the benefits and risks of screening. Risk-adapted approaches that focus on factors such as age and family history could help to optimize the effectiveness of prostate cancer screening and reduce the risk of overdiagnosis and -treatment.