scholarly journals Ever and Annual Use of Prostate Cancer Screening in African American Men

2016 ◽  
Vol 11 (1) ◽  
pp. 99-107 ◽  
Author(s):  
Chanita Hughes Halbert ◽  
Sebastiano Gattoni-Celli ◽  
Stephen Savage ◽  
Sandip M. Prasad ◽  
Rick Kittles ◽  
...  

Since prostate cancer continues to disproportionately affect African American men in terms of incidence, morbidity, and mortality, prostate-specific antigen (PSA) screening plays an important role in early detection, especially when men engage in informed decision making to accept or decline this test. The authors evaluated utilization of PSA testing among African American men based on factors that are important components of making informed decisions. Utilization of PSA testing was evaluated based on whether men had ever had PSA testing and PSA testing during the past year in a community-based sample of African American men ages 50 to 75 ( n = 132). Overall, 64% of men ( n = 85) reported that they had ever had a PSA test; the mean ( SD) age for first use of PSA testing was 47.7 ( SD = 7.4). The likelihood of ever having a PSA test increased significantly with physician communication (odds ratio [OR] = 14.2; 95% confidence interval [CI] = 4.20, 48.10; p = .0001) and with having an annual household income that was greater than $20,000 (OR = 9.80; 95% CI = 3.15, 30.51; p = .0001). The odds of ever having a PSA test were also decreased with each unit increase in future temporal orientation (OR = 0.66; 95% CI = 0.47, 0.93; p = .02). Of the men who had ever had PSA testing, 57% were screened during the past year. Only health insurance status had a significant independent association with having annual PSA testing (OR = 5.10; 95% CI = 1.67, 15.60; p = .004). Different factors were associated significantly with ever having PSA testing and annual testing among African American men. African American men may not be making an informed decision about prostate cancer screening.

2016 ◽  
Vol 10 (6) ◽  
pp. 533-536 ◽  
Author(s):  
John S. Luque ◽  
Levi Ross ◽  
Clement K. Gwede

There have been very few studies to rigorously evaluate the potential of African American barbers to educate men about prostate cancer in the barbershop setting. This research brief presents baseline data from a cross-sectional survey identifying differences in decisional conflict and stage of decision making by screening status from an efficacy trial to educate African American men about informed decision making for prostate cancer screening. Those men who had already received the prostate-specific antigen (PSA) test were more advanced in their stage of decision making and had less decisional conflict about the PSA test than those men who had never received a PSA test. Educational interventions to increase informed decision making with prostate cancer screening must consider previous PSA test history as a mediating variable affecting decision self-efficacy.


2021 ◽  
Vol 3 (1) ◽  
pp. 81-94
Author(s):  
Steven S. Coughlin ◽  
◽  
Deepak Nag Ayyala ◽  
John S. Luque ◽  
Justin Xavier Moore ◽  
...  

Background: The controversy surrounding prostate cancer screening, coupled with the high rates of incidence and mortality among African American men, increase the importance of African American men engaging in an informed decision-making process around prostate cancer screening. Purpose: To examine predictors of prostate cancer screening via the prostatespecific antigen (PSA) test. Secondary objectives were to examine whether African American men have been screened for prostate cancer; their confidence in making an informed choice about whether PSA testing is right for them; and whether they have talked with their provider about PSA testing and engaged in an informed decision-making process around prostate cancer screening. Methods: We conducted a study among a sample of African American men patients ages > 40 years. Results: A total of 65 men completed the questionnaire (response rate = 6.5%). The mean age of the men was 64.4 years. Most of the participants (90.8%) reported a regular healthcare provider and that their provider had discussed the PSA test with them (81.3%). About 84.1% of the men ever had a PSA test, but only 38.0% had one in the past year. Most of the men reported that they make the final decision about whether to have a PSA test on their own (36.5%) or after seriously considering their doctor’s opinion (28.6%). About 31.8% of the men reported that they share responsibility about whether to have a PSA test with their doctor. About half of the participants (49.2%) reported that they have made a decision about whether to have a PSA test and they are not likely to change their mind. The majority of the men (75%) perceived their risk of prostate cancer to be about the same level of risk as other men who were their age. The men’s knowledge of prostate cancer was fair to good (mean prostate cancer knowledge scale = 10.37, SD 1.87). Knowledge of prostate cancer was positively associated with receipt of a PSA test (p < 0.0206). Discussion: The modest overall prostate cancer knowledge among these participants, including their risk for prostate cancer, indicates a need for prostate cancer educational interventions in this patient population.


2018 ◽  
Vol 12 (4) ◽  
pp. 884-893 ◽  
Author(s):  
Jennifer D. Allen ◽  
Ifedayo C. Akinyemi ◽  
Amanda Reich ◽  
Sasha Fleary ◽  
Shalini Tendulkar ◽  
...  

Routine prostate cancer screening is not recommended but African American men who are at higher risk for the disease should be offered the opportunity for shared decision-making with their health-care providers. This qualitative study sought to better understand the potential role of women in educating their male spouses/partners about prostate cancer screening. Nine focus groups were conducted ( n = 52). Women were recruited from a variety of community venues. Those eligible were African American and married to or in a partnership with an African American male age ≥ 45. Women provide numerous types of support to their male partners in an effort to facilitate participation in preventive health care. While women agreed that they would like to educate their partners about prostate cancer screening, they had little information about screening guidelines or the potential harms and limitations. The current findings suggest that women are eager information-seekers and can disseminate information to men and facilitate their efforts to make more informed decisions about prostate cancer screening. Women should be included in educational interventions for to promote informed decision-making for prostate cancer screening.


2018 ◽  
Vol 33 (2) ◽  
pp. 267-278 ◽  
Author(s):  
Otis L. Owens ◽  
Tisha Felder ◽  
Abbas S. Tavakoli ◽  
Asa A. Revels ◽  
Daniela B. Friedman ◽  
...  

Purpose: To evaluate the effects of iDecide on prostate cancer knowledge, informed decision-making self-efficacy, technology use self-efficacy, and intention to engage in informed decision-making among African American men. Design: One-group, pretest/posttest. Setting: Community settings in South Carolina. Participants: African American men, ages 40 years +, without a prior prostate cancer diagnosis (n = 354). Intervention: iDecide, an embodied conversational agent-led, computer-based prostate cancer screening decision aid. Measures: Prostate cancer knowledge, informed decision-making self-efficacy, technology use self-efficacy, and intention to engage in informed decision-making. Analysis: Descriptive statistics, paired t tests, general linear modeling, Spearman correlations. Results: On average, participants experienced significant improvements in their prostate cancer knowledge ( P ≤ .001), informed decision-making self-efficacy ( P ≤ .001), and technology use self-efficacy ( P ≤ .001), postintervention. Additionally, 67% of participants reported an intention to engage in informed decision-making. Conclusion: Given the significant improvements across all measures, this research demonstrates that embodied conversational agent-led decision aids can be used to enhance the capacity for making informed prostate cancer screening decisions among African American men and increase their technology use self-efficacy. One critical limitation of this study is that most men had received prostate cancer screening prior to engaging in our intervention, so the implications of this intervention may be different for men who do not have a history of screening. Additionally, actual engagement in informed decision-making postintervention was not assessed.


2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 308-308
Author(s):  
James T. Kearns ◽  
Oluwaseun Adeyemi ◽  
William E. Anderson ◽  
Timothy C. Hetherington ◽  
Yhenneko J. Taylor ◽  
...  

308 Background: The USPSTF prostate cancer screening guidelines have changed significantly in the past decade, from a recommendation of do not screen in 2012 to a 2018 recommendation that focuses on shared decision making. Additionally, most guidelines further acknowledge that African American men should be screened more intensively than Caucasian men due to increased incidence of prostate cancer and increased prostate cancer mortality. Our objective was to characterize racial disparities in PSA screening in a large healthcare system with a diverse patient population to understand contemporary trends. Methods: This retrospective cohort study used data from the Atrium Health Enterprise Data Warehouse, which includes clinical records from over 900 care locations across North Carolina, South Carolina, and Georgia. Participants included all men ≥ 40 years seen in the ambulatory or outpatient setting during 2014-2018. PSA testing was determined through laboratory data. Clinical and demographic data were collected. Between-group comparisons were conducted using generalized estimating equations models to account for within-subject correlation. Statistical significance was defined as p < 0.05. Results: There were 582,846 individual men seen from 2014-2018, including 416,843 Caucasians (71.5%) and 85,773 African Americans (14.7%). Screening rates declined among all groups from 2014-2018 (see table). African American men were screened at a similar or lower rate than Caucasian men in each year (from 18.6% vs 19.0% in 2014 to 11.9% vs 12.2% in 2018, respectively). Conclusions: PSA screening declined significantly between 2014 and 2018. African American men screened at a similar or lower rate than Caucasian men each year. Given the consensus that African American men should be more intensively screened for prostate cancer, significant racial disparities remain in prostate cancer screening. Further study is warranted to understand patient, provider, and system factors that contribute to disparities in prostate cancer care and outcomes.[Table: see text]


2007 ◽  
Vol 2 (2) ◽  
pp. 156-164 ◽  
Author(s):  
Louie E. Ross ◽  
Barbara D. Powe ◽  
Yhenneko J. Taylor ◽  
Daniel L. Howard

Prostate cancer is the second leading cancer killer in men. Men in general and African American men in particular face crucial decisions regarding prostate cancer screening and perhaps treatment for this disease. Major health organizations agree that men should discuss prostate cancer screening with their physicians or other health care professionals. The purpose of the study was to examine sociodemographic and other correlates of physician-patient discussions regarding the advantages and disadvantages of the prostate-specific antigen (PSA) test among African American men aged 40 or older. A majority of African American men reported having discussed the advantages and disadvantages of prostate cancer screening and/or testing with their physicians before ordering it, and physician-patient discussions about the PSA test were associated with increased screening in African American men. Inasmuch as African American men have greater prostate cancer incidence and mortality over other groups, future attempts should be made to find meaningful correlates of PSA screening and test use to help reduce the burden of this disease.


2020 ◽  
Vol 5 (2) ◽  
pp. 64-69
Author(s):  
Shervin Assari

Background: Prostate cancer screening is more commonly utilized by highly educated people. As shown by marginalization-related diminished returns (MDRs), the effects of socioeconomic status (SES) such as education on the health outcomes are considerably smaller for ethnic minorities than for Whites. The role of MDRs as a source of ethnic health disparities is, however, still unknown. Objectives: The current study had two aims: first, to explore the association between years of schooling and having taken a prostatespecific antigen (PSA) test among men in the US, and second, to explore ethnic differences in this association. Methods: This study was a secondary analysis of data from the National Health Interview Survey (NHIS-2015). The data of 5,053 men aged 55 years or older who were either Latino, non-Latino, African–American, or White were analyzed. Years of schooling was the independent variable. The dependent variable was taking a PSA test sometime during one’s lifetime. Age, region, and employment were the control variables. Ethnicity was the focal moderating variable. Binary logistic regression was used for data analysis. Results: A higher number of years of schooling was associated with higher odds of having taken a PSA test, net of all confounders. Ethnicity showed a significant statistical interaction with years of schooling on having taken a PSA test. This interaction was suggestive of a smaller slope for Latino men than non-Latino men. White and African American men did not show differential effects of years of schooling on having taken a PSA test. Conclusion: Similar to the MDRs patterns in other domains, non-Latino White men show more health gain from their years of schooling than Latino men. Highly educated Latino men still need programs to encourage their use of prostate cancer screening.


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