Factors Associated with Prostate Cancer Screening Test Among African-American Men in the South East

Background and Purpose: African American men bear a high burden of morbidity and mortality from prostate cancer and twice more likely to die from prostate cancer than their white counterparts (American Cancer Society, 2005). African American men are less likely to be screened for prostate cancer (Etzioni, Berry, Legler, & Shaw, 2002; Gilligan, Wang, Levin, Kantoff, & Avorn, 2004; Steele, Miller, Maylahn, Uhler, & Baker, 2000), more likely to be diagnosed at a later stage and less likely to receive aggressive treatment when diagnosed (Horner, 1998; Kla- bunde, Potosky, Harlan, & Kramer, 1998).

Some studies have reported lower levels of participation, knowledge and awareness about prostate cancer among African American men compared to other racial groups (Abbott, Taylor, & Barber, 1998; Agho & Lewis, 2001; Denmark-Wahnefried et al., 1995; Steele et al., 2000). There are cultural barriers, mistrust of the health care system and perceived racism by African American men, which may limit their ability to participate in prostate cancer screening test. These cultural barriers, mistrust of the health care system and perceived racism may affect African American men’s participation in prostate cancer screening within their community. This study focuses on the relationship between cultural barriers, mistrust of the health care system and African American men’s participation in prostate cancer screening test.

Methods: A survey questionnaire related to cultural barriers, mistrust of the health care system and African-American men’s participation in prostate cancer screening test was administered to 304 African American male participants at several prostate cancer educational seminars in the South Eastern part of the U.S.A. The questionnaires were distributed to the participants as part of a prostate cancer educational seminar.

Results: Participants in this study were mostly African-American men (97.3%, n=284) and aged 24-85 (96.7%, n=294). Also, most participants were either married (32.4%, n=95) or single (41.3%, n=121). Majority of the participants indicated they were retired (33.2%, n=98). Lastly, majority had an annual income of less than $10,000 (38.2%, n=116).

The results show that cultural barriers (X²=3.2, p=0.5), mistrust of the health care system and perceived racism (X²=4.6, p=0.3) are not related to African-American men’s participation in Prostate-Specific Antigen (PSA) screening test.

Furthermore, cultural barriers (X²=1.2, p=0.8), mistrust of the health care system and perceived racism (X²=6.6, p=0.2) are not related to African-American men’s participation in Digital Rectal Examination (DRE) screening test.

Finally, demographic factors such as age, employment, income level and education level are strong predictors of African-American men’s participation in prostate cancer screening tests such as PSA, DRE, Fecal occult blood, sigmoidoscopy or colonoscopy.

Conclusions and Implications: Given the findings of the study, more prostate cancer screening programs should be designed targeting African-American families in low-income areas and neighborhoods.