{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T07:08:19Z","timestamp":1786950499144,"version":"build-2736575974"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Objective<\/jats:title>\n Prostate cancer screening enables early detection of asymptomatic cases, but its public health impact depends on timely diagnostic evaluation after a positive result. However, follow-up rates after abnormal screening in community settings remain poorly characterized, particularly in underserved regions of China. This study aimed to investigate the follow-up rate and identify its determinants among men with positive prostate cancer screening results in a community-based cohort in Nanning, Guangxi, to inform targeted interventions.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Community-based cross-sectional survey with a 3-month prospective component.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross-sectional study was conducted in a community in Nanning, Guangxi Zhuang Autonomous Region, from June to August 2021. Male residents aged \u226550\u202fyears (or \u226545\u202fyears with a family history of prostate cancer) who screened positive for prostate cancer (PSA\u202f&gt;\u202f4\u202f\u03bcg\/L) for the first time were eligible. Sociodemographic characteristics, clinical data, and psychosocial factors were collected through community health records and telephone interviews conducted 3\u202fmonths after result notification. Follow-up was defined as attendance at a hospital for further evaluation within 3\u202fmonths of receiving the screening result. Multivariate logistic regression was performed to identify factors associated with follow-up attendance.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 2,939 participants underwent screening, of whom 278 (9.46%) tested positive. After excluding three cases with incomplete data, 275 men were included. Among them, 185 (67.3%) had PSA levels between 4\u201310 \u03bcg\/L, and 90 (32.7%) had PSA\u202f&gt;\u202f10\u202f\u03bcg\/L. Only 81 participants (29.45%) attended a follow-up visit within 3\u202fmonths. Multivariate logistic regression revealed that family awareness of the screening result (OR\u202f=\u202f4.87, 95%CI: 1.81\u201313.10), presence of moderate-to-severe lower urinary tract symptoms (OR\u202f=\u202f4.11, 95% CI: 2.14\u20137.89), and higher prostate cancer knowledge level (OR\u202f=\u202f3.36, 95% CI: 1.78\u20136.36) were independently associated with increased odds of follow-up attendance (all\n p<\/jats:italic>\n \u202f&lt;\u202f0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The follow-up rate among men with positive prostate cancer screening results in this community-based Chinese cohort was alarmingly low (29.45%). Family awareness, lower urinary tract symptom severity, and disease-specific knowledge were identified as independent determinants of follow-up behavior. These findings highlight critical gaps in the screening-to-diagnosis continuum and underscore the need for targeted interventions\u2014particularly those enhancing family involvement, improving symptom recognition, and increasing disease knowledge\u2014to improve follow-up rates and ultimately optimize prostate cancer outcomes in community-based screening programs.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1844078","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T04:34:21Z","timestamp":1778214861000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Low follow-up rate after positive prostate cancer screening in southern China: a community-based cross-sectional survey with a prospective component"],"prefix":"10.3389","volume":"14","author":[{"given":"Zi-Qiang","family":"Li","sequence":"first","affiliation":[{"name":"Department of Urology, Guangxi Academy of Medical Sciences and the People\u2019s Hospital of Guangxi Zhuang Autonomous Region","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Rong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, Guangxi Academy of Medical Sciences and the People\u2019s Hospital of Guangxi Zhuang Autonomous Region","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, Guangxi Academy of Medical Sciences and the People\u2019s Hospital of Guangxi Zhuang Autonomous Region","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue-Fen","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Urology, Guangxi Academy of Medical Sciences and the People\u2019s Hospital of Guangxi Zhuang Autonomous Region","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Wen","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Urology, Guangxi Academy of Medical Sciences and the People\u2019s Hospital of Guangxi Zhuang Autonomous Region","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, Guangxi Academy of Medical Sciences and the People\u2019s Hospital of Guangxi Zhuang Autonomous Region","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"912","DOI":"10.21147\/j.issn.1000-9604.2025.06.04","article-title":"Cancer statistics in China: epidemiology, risk factors, and prevention","volume":"37","author":"Cao","year":"2025","journal-title":"Chin J Cancer Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"5123","DOI":"10.1038\/s41598-025-88392-8","article-title":"Global burden and risk factors of male cancers from 1990 to 2021, with forecasts to 2040","volume":"15","author":"Zhang","year":"2025","journal-title":"Sci Rep"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"824464","DOI":"10.3389\/fmed.2022.824464","article-title":"Different trends in the incidence and mortality rates of prostate cancer between China and the USA: a joinpoint and age-period-cohort analysis","volume":"9","author":"He","year":"2022","journal-title":"Front Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"100653","DOI":"10.1016\/j.curtheres.2021.100653","article-title":"Prostate cancer screening using prostate-specific antigen tests in a high-risk population in China: a cost-utility analysis","volume":"95","author":"Qin","year":"2021","journal-title":"Curr Ther Res Clin Exp"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"11","DOI":"10.6040\/j.issn.1671-7554.0.2018.1053","article-title":"Current status and challenges of prostate cancer screening in China","volume":"57","author":"Zhu","year":"2019","journal-title":"J Shandong Univ Health Sci"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.jncc.2024.01.006","article-title":"Cancer incidence and mortality in China, 2022","volume":"4","author":"Han","year":"2024","journal-title":"J Natl Cancer Cent"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2977","DOI":"10.1002\/ijc.33045","article-title":"Personalized strategies in population screening for prostate cancer","volume":"147","author":"Remmers","year":"2020","journal-title":"Int J Cancer"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1557988319844353","DOI":"10.1177\/1557988319844353","article-title":"An evaluation of follow-up activities of participants from an urban prostate cancer screening event","volume":"13","author":"Drake","year":"2019","journal-title":"Am J Mens Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"305","DOI":"10.13558\/j.cnki.issn1672-3686.2019.04.006","article-title":"Translation and evaluation of the international prostate symptom score","volume":"17","author":"Li","year":"2019","journal-title":"Clin Educ Gen Pract"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"497","DOI":"10.20043\/j.cnki.MPM.202408051","article-title":"Effects of self-rated health and self-care ability and their interaction on depressive symptoms in the elderly","volume":"52","author":"Zhuang","year":"2025","journal-title":"Mod Prev Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.4102\/phcfm.v15i1.3688","article-title":"Knowledge, attitude and practice on screening and early diagnosis of prostate cancer of primary health care providers in the Free State","volume":"15","author":"Benedict","year":"2023","journal-title":"Afr J Prim Health Care Fam Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"355","DOI":"10.3969\/j.issn.1671-315x.2023.05.008","article-title":"The mediating effect of self-acceptance on family cohesion, adaptability and health-promoting lifestyle in colorectal cancer survivors","volume":"23","author":"Yang","year":"2023","journal-title":"Nurs Manag J"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"164","DOI":"10.55131\/jphd\/2024\/220314","article-title":"Health-seeking practices and prostate cancer screening decisions among black men in the United States, Nigeria, and Cameroon","volume":"22","author":"Bolajoko","year":"2024","journal-title":"J Public Health Dev"},{"key":"ref14","first-page":"2488","article-title":"Trend analysis of prostate cancer incidence and mortality among residents in Qiannan prefecture from 2009 to 2018","volume":"46","author":"Jiang","year":"2019","journal-title":"Mod Prev Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1097\/JU.0000000000003491","article-title":"Early detection of prostate cancer: AUA\/SUO guideline part I: prostate cancer screening","volume":"210","author":"Wei","year":"2023","journal-title":"J Urol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.3969\/j.issn.1672-1756.2024.09.014","article-title":"Decision aids for prostate cancer screening: a scoping review","volume":"24","author":"Yang","year":"2024","journal-title":"Chin Nurs Manag"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/j.soncn.2017.02.003","article-title":"Prostate cancer screening","volume":"33","author":"Dunn","year":"2017","journal-title":"Semin Oncol Nurs"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1053698","DOI":"10.3389\/fonc.2022.1053698","article-title":"Poor health literacy associated with stronger perceived barriers to breast cancer screening and overestimated breast cancer risk","volume":"12","author":"Poon","year":"2022","journal-title":"Front Oncol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1080\/13685538.2018.1447558","article-title":"Evaluation of the relationship between compliance with the follow-up and treatment protocol and health literacy in bladder tumor patients","volume":"22","author":"Turkoglu","year":"2019","journal-title":"Aging Male"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2028","DOI":"10.12102\/j.issn.1009-6493.2021.11.034","article-title":"Influence of cross-theoretical model and family participation nursing intervention on the health behavior and quality of life in patients with chronic kidney disease","volume":"35","author":"Li","year":"2021","journal-title":"Chin Nurs Res"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e604","DOI":"10.3399\/bjgp18X698369","article-title":"Effectiveness of reminder strategies on cancer screening adherence: a randomised controlled trial","volume":"68","author":"Wong","year":"2018","journal-title":"Br J Gen Pract"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1577329","DOI":"10.3389\/fpubh.2025.1577329","article-title":"The needs for medical visit accompaniment services among older patients with chronic diseases and their family members: a qualitative study","volume":"13","author":"Chen","year":"2025","journal-title":"Front Public Health"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e45691","DOI":"10.1097\/MD.0000000000045691","article-title":"Outcomes of active surveillance in low-risk prostate cancer: a retrospective cohort study","volume":"104","author":"Baba","year":"2025","journal-title":"Medicine"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1186\/s12889-024-18618-3","article-title":"Longitudinal association between the dynamic nature of depression with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS\/BPH)","volume":"24","author":"Xie","year":"2024","journal-title":"BMC Public Health"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1016\/j.jad.2021.09.045","article-title":"Depressive symptoms in individuals diagnosed with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS\/BPH) in middle-aged and older Chinese individuals: results from the China health and retirement longitudinal study","volume":"296","author":"Zhang","year":"2022","journal-title":"J Affect Disord"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e0187085","DOI":"10.1371\/journal.pone.0187085","article-title":"Qualitative insights into the experiences of living with moderate-to-severe lower urinary tract symptoms among community-dwelling ageing males","volume":"12","author":"Suen","year":"2017","journal-title":"PLoS One"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1979","DOI":"10.1177\/10497323221129262","article-title":"Reaching a tipping point: a qualitative exploration of quality of life and treatment decision-making in people living with benign prostatic hyperplasia","volume":"32","author":"Husted","year":"2022","journal-title":"Qual Health Res"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"e71214","DOI":"10.1002\/cam4.71214","article-title":"Barriers & facilitators to help-seeking behaviour for abnormal lower urinary tract symptoms in men: systematic review","volume":"14","author":"McIntosh","year":"2025","journal-title":"Cancer Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1007\/s11934-020-01006-w","article-title":"Analyzing and characterizing why men seek care for lower urinary tract symptoms","volume":"21","author":"Landau","year":"2020","journal-title":"Curr Urol Rep"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1016\/j.juro.2017.07.067","article-title":"Reasons for seeking clinical care for lower urinary tract Symptoms: a mixed methods study","volume":"199","author":"Griffith","year":"2018","journal-title":"J Urol"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1844078\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T04:34:44Z","timestamp":1778214884000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1844078\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,8]]},"references-count":30,"alternative-id":["10.3389\/fpubh.2026.1844078"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1844078","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,8]]},"article-number":"1844078"}}