Prostate Cancer Screening Behavior Research Articles

Religiousness and Prostate Cancer Screening in African American Men

This study was designed to examine the relationship between religiousness (organized, nonorganized, and intrinsic) and religious problem solving (collaborative, deferring, and self-directing) in prostate cancer screening (PCS) attitudes and behavior. Men (N = 481) of African descent between the ages of 40 and 70 participated. Hierarchical regression analyses revealed that religiousness and self-directed problem solving were associated with PCS attitudes. Intrinsic religiousness was associated with PCS attitudes after controlling for health and organized religiousness. Religiousness was not associated with PCS behavior. Intrinsic religiousness may be an important dimension of religiousness to be considered in tailoring cancer interventions for individuals from faith-based communities.

Preventive, Lifestyle, and Personal Health Behaviors Among Physicians

This study examines personal health behaviors and wellness, health-related lifestyles, and prevention screening practices among licensed physicians. An anonymous questionnaire was mailed to a random sample of 1,875 physicians practicing in California. Data from 763 returned questionnaires (41%) were analyzed. Our data show that 7% of this sample were clinically depressed, 13% reported using sedatives or tranquilizers, over 53% reported severe to moderate stress, and only 38% described their level of daily stress as slight. About 4% self-reported recent marijuana use. More than 6% screened positive for alcohol abuse and 5% for gambling problems. Thirty-five percent of participants reported "no" or "occasional" exercise. About 27% self-reported "never" or "occasionally" eating breakfast. In addition, 34% reported 6 or fewer hours of sleep daily, while 21% self-reported working more than 60 hours per week. Physicians' excessive number of work hours (more than 65 hours per week) was associated with lack of exercise, not eating breakfast, and sleeping fewer than 6 hours per night. California physicians report breast, cervical, colorectal, and prostate cancer screening behaviors that exceeded population estimates in California and Healthy People 2010 national goals. Additional interventions designed to improve physicians' lifestyles and personal health behaviors should be encouraged. A focus on creating healthy lifestyles will benefit physicians as much as the general population.

Religious Involvement and Prostate Cancer Screening Behaviors Among Southeastern African American Men

This study examined the relationship between religious involvement and prostate cancer screening behavior among a probability sample of 199 African American men. Religious involvement was assessed by telephone via a multidimensional instrument. Engaging in religious behaviors was predictive of reporting a digital rectal examination (DRE) within the past year. Religious beliefs and behaviors were predictive of behavioral intention for DRE in the next 6 months. Religious behaviors were predictive of reporting an appointment for a DRE in the next 6 months. All analyses were controlled for age, education, and marital status. None of the predictions were significant for prostate-specific antigen testing. Understanding the role of religious involvement in cancer beliefs and screening is important. Such knowledge can inform educational interventions for this group, which is disproportionately affected by prostate cancer.

Personal Factors Affecting African-American Men’s Prostate Cancer Screening Behavior

Although there are significant controversies about prostate cancer screening, it is the only method recognized to combat prostate cancer through early detection and appropriate treatment. The primary goal of this study was to identify personal factors influencing African-American men's participation in prostate cancer screening. Two cross-sectional mail surveys were conducted over one year to test the validity of the Attitude-Social Influence-Efficacy model in predicting prostate cancer screening. Data were collected from African-American men age > or =40. The study hypotheses were tested using multiple linear regression and logistic regression analyses One-hundred-ninety-one African-American men participated in the first cross-sectional survey, and 65 African-American men responded to the follow-up survey a year later. The participants were mostly African-American men who were born and grew up in America, were 50-59 years of age, had some college training, were married, were urban residents, had full-time employment status and had a household income of $20,000-$39,000. The key determinants of intention to undergo prostate cancer screening were attitude, perceived behavioral control, past behavior and perceived susceptibility. Attitude was the primary determinant of screening behavior. To foster appropriate prostate cancer detection activities, the modifiable factors identified in this study should be considered.

Does educational printed material manage to change compliance with prostate cancer screening?

The effects of printed educational material on cancer screening in women (Pap test and mammography) are well documented and confirmed by several studies. The aim of our study was to evaluate the impact of similar printed educational material on prostate cancer screening by PSA and DRE. Thousand five hundred men aged between 50 and 86 years of age, who attended our institutions for various medical conditions except prostate-related conditions, were randomly assigned to two study groups. Men in the informed group, received an educational leaflet with simple, general information on prostate cancer screening methods given by their physician along with treatment and other regular recommendations, while men in the non-informed group, were only informed by their physician in the examination room during an interview. After 24 months, there was no statistically significant difference between the two groups in terms of DRE screening. The percentages of men who were actually screened by DRE were 4 and 5% in the informed and non-informed groups, respectively, while the difference in the percentages of PSA screening was of statistical significance, with 31% of men screened in the non-informed group as compared to 93% of men screened in the informational leaflet group. A single, one-shift distribution of printed educational material on prostate cancer screening, changed their attitude regarding prostate cancer screening only in favour of PSA testing, while did not manage to change the DRE acceptance behavior. However, since the combination of the two tests is more sensitive for diagnosis than either one alone, there is a need of introducing intervention strategies, in the efforts of ameliorating the prostate cancer screening behavior.

Pharmacists as health educators and risk communicators in the early detection of prostate cancer

Background Community pharmacist involvement in health communication could assist in ameliorating health disparities in a number of areas. One such area is the early detection of prostate cancer in patients. Objectives The primary goal of this study was to explore the role of pharmacists as health educators and risk communicators in the prevention of prostate cancer mortality. The study objectives were to (1) describe community pharmacists' attitudes and beliefs related to serving as health educators and risk communicators on prostate cancer; and (2) assess community pharmacists' knowledge about prostate cancer. Methods A cross-sectional survey methodology was used to collect data from pharmacists present at the Florida Pharmacy Association 115th Annual Meeting. Eighty-nine pharmacists were administered a survey to measure their knowledge, attitudes, and beliefs using a structured survey form. Descriptive statistics and multiple regression analyses were used to analyze participants' responses. Results The mean age of participants was 45 years and they were mostly male, White (non-Hispanic) with B.S. Pharmacy as the highest degree. The face validity of the survey instrument was established through pilot test. Participants' views about offering prostate cancer education for patients were generally positive; however, participants' score on the general prostate cancer knowledge scale for patients was lower than expected for health care professionals, with approximately 45% of the participating pharmacists scoring less than 80% on the Odedina Prostate Cancer Screening Behavior Scale. Based on multiple regression analyses, participants' gender and disease state management status were found to be significantly associated with prostate cancer knowledge, whereas prostate cancer knowledge, technician staffing, and the type of pharmacy significantly predicted pharmacists' interest in prostate cancer education. Conclusions Although the community pharmacists in this study were willing to take on responsibilities in the prevention and detection of prostate cancer, their knowledge base may serve as an impediment to action. Future research may identify means by which to educate pharmacists and enable their involvement.

Relationship Between Body Mass Index and Prostate Cancer Screening in the United States

Obesity is associated with more advanced disease and worse outcomes in men with prostate cancer. To our knowledge the relationship between obesity and prostate cancer screening behavior in men 40 or older is unknown. Thus, we examined associations between body mass index and prostate cancer screening behavior. We used the 2002 Behavioral Risk Factor Surveillance System to study prostate cancer screening in a representative sample of 57,827 men 40 years or older. Primary outcomes were the proportion of men ever screened and the proportion screened in the last year for prostate cancer. Obese men were more likely than normal weight men to have had a prostate specific antigen test (62.1% vs 56.1%, p <0.001) and to have had a prostate specific antigen test in the last year (44.2% vs 38.2%, p <0.001). After controlling for sociodemographic characteristics obese men remained more likely than normal weight men to have had a prostate specific antigen test (OR 1.46, 95% CI 1.33-1.61) and to have had a prostate specific antigen test in the last year (OR 1.42, 95% CI 1.30-1.55). Respondents reporting an ongoing relationship with a physician (OR 2.88, 95% CI 2.57-3.22) and black nonHispanic men vs white men (OR 1.58, 95% CI 1.38-1.81) were also more likely to have had a prostate specific antigen test in the last year. Obese men are more likely than normal weight men to be screened for prostate cancer. Associations between advanced stage, worse outcomes and obesity may not be explained by disparities in the screening of obese men for prostate cancer.

On the importance of being ethnic: Coping with the threat of prostate cancer in relation to prostate cancer screening.

The relation between coping with a possible prostate cancer diagnosis and screening behavior was examined in men from seven precise ethnic groups. Five coping styles differed in their likelihood of use across ethnic groups and had somewhat different associations with frequency of prostate-specific antigen (PSA) testing. As expected, PSA test frequency differed among men from different ethnic groups and was differentially predicted by coping styles. Analyzing the results using typical groups of White, Black, and Hispanic, rather than precise ethnic groups, obscured these results. Researchers investigating psychological variables in preventive health behaviors must analyze diversity within the framework provided by ethnic specificity. Such an approach will guide the development and provision of interventions that are more sensitive to the characteristics of specific ethnic groups of at risk men.

The Relationship Between Patient-Provider Discussions about Prostate Cancer Screening and Screening Behavior in Washington State

The Relationship Between Patient-Provider Discussions about Prostate Cancer Screening and Screening Behavior in Washington State

Prostate Cancer Screening Behavior in Men from Seven Ethnic Groups: the Fear Factor

Rates of prostate cancer screening are known to vary among the major ethnic groups. However, likely variations in screening behavior among ethnic subpopulations and the likely role of psychological characteristics remain understudied. We examined differences in prostate cancer screening among samples of 44 men from each of seven ethnic groups (N = 308; U.S.-born European Americans, U.S.-born African Americans, men from the English-speaking Caribbean, Haitians, Dominicans, Puerto Ricans, and Eastern Europeans) and the associations among trait fear, emotion regulatory characteristics, and screening. As expected, there were differences in the frequency of both digital rectal exam (DRE) and prostate-specific antigen (PSA) tests among the groups, even when demographic factors and access were controlled. Haitian men reported fewer DRE and PSA tests than either U.S.-born European American or Dominican men, and immigrant Eastern European men reported fewer tests than U.S.-born European Americans; consistent with prior research, U.S.-born African Americans differed from U.S.-born European Americans for DRE but not PSA frequency. Second, the addition of trait fear significantly improved model fit, as did the inclusion of a quadratic, inverted U, trait fear term, even where demographics, access, and ethnicity were controlled. Trait fear did not interact with ethnicity, suggesting its effect may operate equally across groups, and adding patterns of information processing and emotion regulation to the model did not improve model fit. Overall, our data suggest that fear is among the key psychological determinants of male screening behavior and would be usefully considered in models designed to increase male screening frequency.

Knowledge, beliefs and barriers associated with prostate cancer prevention and screening behaviors among African-American men.

Knowledge, beliefs and barriers associated with prostate cancer prevention and screening behaviors among African-American men.

Impact of Race, Age, Income, and Residence on Prostate Cancer Knowledge, Screening Behavior, and Health Maintenance in Siblings of Patients with Prostate Cancer

ObjectiveThis study evaluates self-reported changes in knowledge of prostate cancer (CaP), CaP screening behavior and other health-related activities in men whose brothers have been diagnosed with prostate cancer and to characterize those demographic subgroups of siblings at particular risk of failure to change their behavior. Methods112 men were surveyed to self-assess their knowledge of CaP both before and after their brother’s diagnosis. In addition, siblings were questioned with regard to other health-related behaviors before and after their brother’s diagnosis. Demographic characteristics including age, race, income, and area of residence were also reported. Results were analyzed to determine how a brother’s diagnosis with CaP affects changes in prostate cancer knowledge, screening behavior and other health related activities in these high-risk patients. ResultsThe impact of a brother’s diagnosis of CaP affects only 40% of siblings with regard to CaP knowledge. This knowledge appears to translate into increased screening behavior and other-health-related activity in these men. Unfortunately, more than half of men have no change in CaP knowledge and correspondingly no change in screening behavior. Siblings who are older, earn less, and live in rural areas have a lower baseline knowledge of CaP and are less likely to improve their self-assessed knowledge. On regression analysis, correlates of improvement in CaP knowledge included (1) those discussing with their primary physician (OR=6.6), (2) Caucasians (OR=2.7) and (3) non-smokers (OR=3.1). Improvements in prostate cancer knowledge were found to be predictive of subsequent participation in CaP screening and annual physical exams. ConclusionsIncreased attention should be paid to siblings of CaP patients in efforts to improve their knowledge and thereby participation in screening as these patients are at an increased risk of development of this disease. Efforts should be made to educate siblings who are older, of lower income, African American, and rural residents with regard to CaP, as these subgroups appear less likely to change their knowledge and screening behavior despite their sibling’s diagnosis.

Prostate Cancer Screening Perceptions, Knowledge and Behaviors among African American Men: Focus Group Findings

The purpose of the study was to explore, using focus groups, the knowledge, perceptions, attitudes, and behavior of African American men concerning prostate cancer and screening for the disease using the prostate specific antigen and the digital rectal examination. Twelve focus groups (n=104) were conducted among African American men 40 years of age and older, residing in three counties in the metropolitan area of Baltimore, Maryland. The results of the study show various barriers to screening among the target population, which include limited knowledge about the disease, lack of access to screening services, embarrassment and fear of a positive diagnosis. Additional barriers reported were distrust of medical professionals and the government, reluctance to talk about sex-related health problems, complacency about the possibility of having the disease, and belief that prostate cancer is related to sexual behavior. Positive beliefs, hope, and familiarity with the disease were enabling factors for prostate cancer screening. The focus groups served to open doors to communities from the research and medicine world, and heightened awareness of prostate cancer.

Prostate Cancer Screening Perceptions, Knowledge and Behaviors among African American Men: Focus Group Findings

The purpose of the study was to explore, using focus groups, the knowledge, perceptions, attitudes, and behavior of African American men concerning prostate cancer and screening for the disease using the prostate specific antigen and the digital rectal examination. Twelve focus groups (n=104) were conducted among African American men 40 years of age and older, residing in three counties in the metropolitan area of Baltimore, Maryland. The results of the study show various barriers to screening among the target population, which include limited knowledge about the disease, lack of access to screening services, embarrassment and fear of a positive diagnosis. Additional barriers reported were distrust of medical professionals and the government, reluctance to talk about sex-related health problems, complacency about the possibility of having the disease, and belief that prostate cancer is related to sexual behavior. Positive beliefs, hope, and familiarity with the disease were enabling factors for prostate cancer screening. The focus groups served to open doors to communities from the research and medicine world, and heightened awareness of prostate cancer.

Effects of False-Positive Prostate Cancer Screening Results on Subsequent Prostate Cancer Screening Behavior

Abstract Objectives: Little is known about screening behavior following a false-positive prostate cancer screening result, which we have defined as a screening result with “abnormal/suspicious” labeling that did not result in a prostate cancer diagnosis within 14 months. The purpose of this analysis was to examine whether age, race, education, or previous false-positive prostate cancer screening results via prostate-specific antigen or digital rectal exam predict decision to obtain subsequent prostate cancer screening. Methods: Data were drawn from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. The study sample consisted of 2,290 older men (mean age, 62.8 years; range, 55-75 years) who had false-positive (n = 318) or negative (n = 1,972) prostate-specific antigen or digital rectal exam baseline prostate cancer screening results. Multivariable logistic regression was used to assess the effect of false-positive results on subsequent prostate cancer screening behavior, adjusting for all covariates. Results: The multivariable model showed that being African American (P = 0.016), and having a high school education or less (P = 0.007), having a previous false-positive prostate cancer screening result (P &amp;lt; 0.001), were predictive of not returning for prostate cancer screening in the following screening trial year. Conclusion: The study results highlight the importance of shared decision making between patients and their providers regarding the risks and benefits of prostate cancer screening, and follow-up options for abnormal prostate cancer screening results. Shared decision making may be especially important for African American men, whom prostate cancer disproportionately affects.

Culture, Black Men, and Prostate Cancer: What is Reality?

The worldwide incidence of prostate cancer is higher among American black men than any other male group. In the United States, lack of participation in screening for prostate cancer by black men is influenced by several cultural factors, including knowledge, health beliefs, barriers, and relationships with primary healthcare providers. We used the qualitative and paralleling descriptive quantitative findings of a mixed-method longitudinal study exploring prostate cancer screening behaviors among 277 black men. Five themes were identified as critical elements affecting men's screening for prostate cancer: lack of knowledge, communication, social support, quality of care, and sexuality. These themes were associated with a sense of disconnectedness by black men from the healthcare system and contributed to nonparticipation in prostate cancer early detection activities. Lack of discussion about the decision to screen for prostate cancer and general lack of culturally appropriate communication with healthcare providers has engendered distrust, created fear, fostered disconnect, and increased the likelihood of nonparticipation in prostate cancer screening among black men.

Race and prostate cancer: Attitudes toward diagnosis and treatment among newly diagnosed patients

6056 Background: Patient factors potentially affecting prostate cancer (PC) screening and treatment behavior may differ by race. Methods: Using Rapid Case Identification in the North Carolina Tumor Registry, we identified 84 newly diagnosed African American (AA) and 253 Caucasian (C) PC patients. Interviews assessed their socioeconomic position, health attitudes, access to care, pretreatment symptoms and treatment choices. Most men had begun their treatment. Results: AA men were younger, had less education, and lower income compared to C men (all P<0.001), but racial groups did not differ in insurance coverage or their proximity to their site of care. However, AA men more often reported foregoing a doctor's care even when they perceived a need, less often saw the same MD regularly, and reported less trust in their MD about cancer. AA men reported more relatives with prostate cancer, greater risk of and fear of prostate cancer than other men, and greater belief that fear causes most men to put off checking their prostate. AA and C men did not differ on the first evidence for their cancer, although it arose more often at special screening sessions for AA men. Their treatment choices did not differ from C men, despite a greater preference to avoid surgery. AA men reported a lower self-assessment of global health, but their self-reported ability to perform social roles without physical or mental health limitations, and their urinary, bowel and sexual function were the same as those of C men. Conclusions: Although less well educated, AA men in North Carolina are aware of their greater risk of PC and the need for treatment when diagnosed, and they tend to assume greater responsibility for getting cancer and delaying diagnosis. However, absence of strong ties to a primary physician, mistrust of physicians in general, constrained opportunities to utilize needed care, and fear of prostate cancer may present barriers to timely diagnosis. No significant financial relationships to disclose.

Race and prostate cancer: Attitudes toward diagnosis and treatment among newly diagnosed patients

6056 Background: Patient factors potentially affecting prostate cancer (PC) screening and treatment behavior may differ by race. Methods: Using Rapid Case Identification in the North Carolina Tumor Registry, we identified 84 newly diagnosed African American (AA) and 253 Caucasian (C) PC patients. Interviews assessed their socioeconomic position, health attitudes, access to care, pretreatment symptoms and treatment choices. Most men had begun their treatment. Results: AA men were younger, had less education, and lower income compared to C men (all P<0.001), but racial groups did not differ in insurance coverage or their proximity to their site of care. However, AA men more often reported foregoing a doctor's care even when they perceived a need, less often saw the same MD regularly, and reported less trust in their MD about cancer. AA men reported more relatives with prostate cancer, greater risk of and fear of prostate cancer than other men, and greater belief that fear causes most men to put off checking their prostate. AA and C men did not differ on the first evidence for their cancer, although it arose more often at special screening sessions for AA men. Their treatment choices did not differ from C men, despite a greater preference to avoid surgery. AA men reported a lower self-assessment of global health, but their self-reported ability to perform social roles without physical or mental health limitations, and their urinary, bowel and sexual function were the same as those of C men. Conclusions: Although less well educated, AA men in North Carolina are aware of their greater risk of PC and the need for treatment when diagnosed, and they tend to assume greater responsibility for getting cancer and delaying diagnosis. However, absence of strong ties to a primary physician, mistrust of physicians in general, constrained opportunities to utilize needed care, and fear of prostate cancer may present barriers to timely diagnosis. No significant financial relationships to disclose.

453: Impact of Race, Age, Income, and Residence on Prostate Cancer (CAP) Knowledge, Screening Behavior, and Health Maintenance in Siblings of Patients With Cap

453: Impact of Race, Age, Income, and Residence on Prostate Cancer (CAP) Knowledge, Screening Behavior, and Health Maintenance in Siblings of Patients With Cap

Men's attitudes toward prostate cancer and seeking prostate-specific antigen testing.

Although the Australian Cancer Society recommends against performing PSA tests to screen for prostate cancer, many Australian men currently undergo such screening. This study investigated attitudinal variables that may predict prostate cancer screening behaviors in this context. A questionnaire was administered by mail in a two-phase procedure, first to a sample of 1,461 men (46% response), then to 919 men from the initial sample. Prostate cancer screening behaviors of men > 40 years old were examined. The questionnaire assessed worry about prostate cancer, perceived vulnerability to prostate cancer, belief in the efficacy of PSA testing for detection, having received a PSA test for detection, and the presence of urologic symptoms at the time of testing. Men who had had PSA testing with urologic symptoms at the time of the test were more worried about prostate cancer and perceived themselves as more vulnerable to prostate cancer compared with both asymptomatic tested and untested men. Men who had undergone PSA testing believed the test to be more effective in the detection of prostate cancer than did men who had not. Urologic symptoms act as a risk cue for men to prostate cancer. Asymptomatic men should be considered separately from symptomatic men in the investigation of psychological variables predictive of seeking screening for prostate cancer. These findings are discussed in terms of both the focus and design of interventions to alter prostate cancer screening behavior and their implications for the clinical management of men with urologic symptoms.