Urban-Rural Differences in Self-Reported Physician-Diagnosed BPH and Associated Factors Among Older Men: A Cross-Sectional Analysis of a National Survey.

Benign prostatic hyperplasia (BPH) is highly prevalent among older men, yet its population-level assessment often depends on physician diagnosis, which may vary by healthcare access and reporting behavior. In China, substantial urban-rural differences in healthcare utilization raise questions about whether reported differences in BPH reflect true variation or diagnostic patterns. This study therefore examined urban-rural differences in self-reported physician-diagnosed BPH and associated factors using nationally representative data. We conducted a cross-sectional analysis of 8455 men aged 45 years and older using data from Wave 4 (2018) of the China Health and Retirement Longitudinal Study (CHARLS). BPH status was defined based on self-reported physician diagnosis. Urban-rural differences in reported BPH were compared, and multivariable logistic regression models were used to examine factors associated with reported BPH diagnosis. Of 8455 participants, the overall proportion reported a physician diagnosis of BPH was 11.9%, with subgroup-specific proportions of 18.4% in urban men and 10.1% in rural men. After adjustment for sociodemographic, lifestyle, and health-related variables, rural residence was associated with lower odds of reporting BPH (aOR 0.61, 95% CI 0.51-0.72). Several associations differed by residence, including a positive association between moderate physical activity and reported BPH in urban men, and inverse associations for longer sleep duration and regular alcohol consumption in rural men (