Reasons for Participation in Prostate Cancer Screening Among Black Males

Background and Purpose: Prostate cancer [PCa] is the most commonly diagnosed cancer among men and the second most common cause of cancer mortality among men in America. Black men have a mortality rate from PCa twice that of Caucasian men. Research concerning the reasons for participation in PCa screening remains limited among Black men. This study seeks to understand reasons influencing participation in PCa screening among Black men.

Methods: Using a non-experimental survey design with purposive sampling, men living in an urban and rural areas were approached in community-based locations (e.g., barbershops, churches, health fairs, health centers) and recruited to participate (N = 183). Men between the ages of 35-65 who had not been diagnosed with or treated for PCa were eligible to participate. Participants were invited to complete a survey regarding Prostate Cancer awareness, knowledge and beliefs either in-person or online. This study examines the 17-item Reasons for Participation in Prostate Cancer Screening (RPPCS) measure. This measure contains four domains psychological (2 items), convenience (4 items), awareness (4 items), and medical (7 items). All questions were anchored on a 4-point scale from 1 (Not Important) to 4 (Very Important). Scale items were summed up to indicate participants’ perceived importance of PCa screening. The possible range of scores is from 17–68 with lower scores suggesting an attitude in which participating in screening was of lesser importance.

Results: The mean age of the participants was 46.37 (SD=8.26), with 55% of the men reporting no college education, while 86.3% of participants reporting income of $40,000 or higher. Eighty percent of respondents reported never undergoing a digital rectal examination. Reliability analysis of the RPPCS was adequate at Cronbach’s alpha at .80 while subscale alphas were all above. 70. Mean score was 49.46 (SD = 7.4).  In terms of subscales, for psychological domain, the average score was 5.90 (SD = 1.38). For convenience domain, the average score was 12.42 (SD = 2.14). For Awareness domain, the average score was 9.86 (SD = 2.56). Lastly, for medical domain, the average score was 21.29 (SD = 4.28). Independent t-tests revealed no significant relationship between education (i.e., with college degree and no college degree) and the RPPCS. Correlation tests indicated that lower income is associated with lower perceived importance of having a second opinion on screening results and pain or difficulty urinating.

Conclusions and Implications: Study findings indicate that the majority of the participants had adequate perceived importance of reasons for participation. Income is related to the medical domain of the RPPCS. As members of interdisciplinary care teams, medical social workers can play important roles in health education on the important medical reasons for PCa screening. Education concerning PCa is necessary across income and educational statuses for Black men.