Dear editor: With an estimated 1 600 000 new cases and 366 000 deaths every year, prostate cancer (PCa) is the most commonly diagnosed cancer and cancer-related cause of death in men around the world.¹1. Fitzmaurice C, Allen C, Barber RM, Barregard L, Bhutta ZA, Brenner H, Fleming T. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017;3(4):524-48. https://doi.org/10.1001/jamaoncol.2016.5688
https://doi.org/10.1001/jamaoncol.2016.5... In Mexico, PCa was one of the most common types of cancer diagnosed in men between 2000 and 2013, having one of the highest cancer-related mortality rates.²2. Mohar-Betancourt A, Reynoso-Noverón N, Armas-Texta D, Gutiérrez-Delgado C, Torres-Domínguez JA. Cancer trends in Mexico: Essential data for the creation and follow-up of public policies. J Glob Oncol. 2017;3(6):740-8. https://doi.org/10.1200/JGO.2016.007476
https://doi.org/10.1200/JGO.2016.007476... It has been pointed out that Mexico lacks a coordinating entity for cancer prevention and control and that the health system is fragmented which has led to inadequate control of patients undergoing PCa testing.³3. Reynoso-Noverón N, Meneses-García A, Erazo-Valle A, Escudero-de los Ríos P, Kuri-Morales PA, Mohar-Betancourt A. Challenges in the development and implementation of the National Comprehensive Cancer Control Program in Mexico. Salud Publica Mex. 2016;58(2):325-33. https://doi.org/10.21149/spm.v58i2.7804
https://doi.org/10.21149/spm.v58i2.7804... The present study aimed to seek socioeconomical factors associated with frequency of PCa testing in Mexico. We conducted a cross-sectional analysis of 5 339 Mexican males years old from the fourth wave of the Mexican Health and Aging Study (MHAS, 2015).⁴4. Wong R, Michaels-Obregon A, Palloni A. Cohort profile: the Mexican health and aging study (MHAS). Int J Epidemiol. 2017;46(2):e2. https://doi.org/10.1093/ije/dyu263
https://doi.org/10.1093/ije/dyu263... Testing activity regarding PCa in the past two years was obtained from a self-reported question. Independent variables included years of education and financial situation. Adjusted multivariate logistic regression model was performed. Following, odds ratio (OR) with a confidence interval (CI) of 95% were obtained.

A 30.9% of the sample reported that had undergone PCa testing within the last two years. Significant differences were found in the bivariate analysis. Subjects that had attended school (7 or 1-7 years) were more commonly tested than those who did not attend it (41.1 vs 46.9 vs 12.0%; p<0.001). Likewise, there was a higher prevalence of subjects with a poor financial situation (70.7 vs 29.3%; p<0.001). Such associations were also found to be significant after model adjustment (Education OR 1.96; CI 1.57 to 2.45; p<0.001; Financial situation OR 0.73; CI, 0.626 to 0.85; p<0.001 [table I]).

These results suggest that education level may be associated with increased awareness of PCa testing and access to PCa testing programs. Similarly, financial status relevance might highlight a disparity in access to and utilization of PCa testing. These findings are consistent with other studies showing that health care utilization among older Mexicans is associated with socioeconomic inequalities.⁵5. Wong R, Díaz JJ. Health care utilization among older Mexicans: health and socioeconomic inequalities. Salud Publica Mex. 2007;49(S4):505-14. https://doi.org/10.1590/S0036-36342007001000010
https://doi.org/10.1590/S0036-3634200700...

A revision of current strategies and public policies allowing a more equal access for all the population could be useful in order to improve current PCa testing practices in Mexico.

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