Prostate Cancer and African American Males: Influence of Health Beliefs on Awareness and Knowledge of Prostate Cancer Screening Participation

Purpose: According to the American Cancer Society an estimated 218,890 new cases of prostate cancer will be diagnosed in men in the United States in 2007 of which 27,050 may die of the disease. Prostate cancer is the second leading killer in men in the U.S. behind heart disease. Age, high-fat diet, African American race, and family history of prostate cancer are major risk factors for contracting the disease. Advances in medical technology have lead to earlier diagnosis and improved treatment outcomes, thus contributing to decreasing mortality rates from the disease. Notwithstanding medical advancement in diagnosis and treatment, African American males have not realized noticeable gains in prostate cancer survival. If diagnosed early, prostate cancer has one of the highest survival rates of all cancers. Nonetheless, African American men still have a mortality rate 2.5 times that of Caucasian men. A contributing factor to this disparity according to extant research is that African American men participate less frequently in routine diagnostic screenings for the disease. While screening efforts often target men over the age of 50, several medical organizations suggest that for men at higher risk of contracting prostate cancer screening should begin as early as age 40. Little is known about the attitudes, knowledge and perceptions regarding prostate cancer among African American men who have not reached screening age. Methods: Using a cross-sectional survey design methodology potential participants were identified through community-focused recruitment strategies (e.g., minority health fairs, churches, barbershops). The survey was self-administered. The conceptual framework guiding this study was based on the Health Beliefs Model. Two key measures in the survey were the 17-item Reasons for Participation in Prostate Cancer Screening [RPPCS] and 20-item Beliefs About Prostate Disease [BAPD]. Demographic information including family history of prostate cancer was also collected. Results: Fifty-six African American men participated in the study. The mean age of the participants was 38.83 and 52% of the respondents were married. When asked about the location and function of the prostate glad, 36% and 24% respectively answered incorrectly. The RPPCS had an alpha of .90 while the alpha for the BAPD was .83. Of the four subscales in the RPPCS medical (m=21, sd=6.2) and convenience (m=12, sd=2.9) were found to be the highest rated reasons for getting screened. Participants reported higher beliefs in perceived barriers to achieving desired health outcomes. A positive correlation (r=.414, p<.01) was found between the RPPCS and BAPD. Men with a first-degree relative diagnosed with prostate cancer reported slightly higher participation in prostate cancer screening than men without such a relative. Conclusions & Implications: Social work professionals in conjunction with healthcare providers must collaborate in order reduce the continuing health disparities related to accessing screening and treatment for prostate cancer. The results of this study suggest that social workers can play an important role in facilitating community education efforts to men faced with seeking information regarding prostate cancer, screening options, the psychosocial effects of prostate cancer, and their need for accurate information.