Academic journal article The Journal of Men's Studies

Factors Associated with Cancer Family History Communication between African American Men and Their Relatives

Academic journal article The Journal of Men's Studies

Factors Associated with Cancer Family History Communication between African American Men and Their Relatives

Article excerpt

The American Cancer Society reports that 25 percent of all deaths in the United States are the result of cancer and that nearly one-third of Americans will develop cancer in their lifetime (American Cancer Society [ACS], 2011; Kelly, Shedlosky-Shoemaker, Porter, Remy, DeSimone, & Andrykowski, 2007). Based on data from the ACS, African American men have the highest mortality and poorest survival rates for most cancers among all racial/ethnic groups in the U.S. (ACS). With a death rate 32 percent higher than that of white men for all types of cancer combined, African American men are less likely to be alive at each stage of a cancer diagnosis as well as five years after a cancer diagnosis when compared to their white male counterparts (ACS). While evidence suggests that a range of complex and multi-level social and economic disparities contribute to the disproportionate cancer burden of African American men (ACS), there are also personal and familial factors well-known to affect risk, such as family history of cancer (FHC). This study seeks to extend previous studies on cancer burden among African American men by examining the various socio-demographic, health information, health access, and behavioral health factors associated with the occurrence of FHC communication between African American men and their relatives.

The literature is replete with evidence that FHC alone is a significant risk factor for several cancers including breast, colorectal, and prostate (Acheson, 2011; Shah, Zhu, Palmer, & Wu, 2007; Ziogas et al., 2011). In particular, having a first-degree relative (i.e., parent, sibling, or child) diagnosed with cancer substantially increases an individual's relative risk for the disease compared to the general population (Guttmacher, Collins, & Carmona, 2004; Yoon, Scheuner, Peterson-Oehlke, Gwinn, Faucett, & Khoury, 2002; Ziogas et al.). For example, individuals with a colorectal FHC are two to six times more likely to develop the disease than individuals with no FHC (Ziogas et al.) while men with a first-degree male relative with prostate cancer are more than twice as likely to develop the disease as men without that FHC (Shah et al.). These reports are essential from a population health perspective because it is estimated that more than 22% of individuals in the U.S. have a familial or hereditary predisposition to cancer that may warrant earlier, more frequent, or more sensitive cancer screenings for the purposes of prevention or early detection of malignancies (ACS, 2011; Ziogas et al.).

Collecting FHC information is one of the most efficacious ways of identifying individuals with higher than average cancer risk, yet the success of obtaining such information is met by a number of individual and system-level challenges. In a state-of-the-science report, the National Institutes of Health (NIH, 2009) described evidence of several individual, family, and health-system barriers to the collection, reporting, and use of family health histories for the purposes of prevention and treatment in clinical care (NIH). This NIH report cited the lack of health insurance, low income of patients, lack of time and compensation for physicians, and unfamiliarity with technology and methods for interpreting family history data among physicians as factors impeding family health history use in clinical settings (NIH). This is unfortunate considering that the act of communicating with one's family about FHC and relaying that information to a health provider has implications for earlier than usual preventive interventions, cancer screening frequency, referrals to genetic testing, patient education, and other potentially modified surveillance recommendations that could reduce cancer-related disparities for individuals at moderate to high-risk (Kelly, Sturm, Kemp, Holland, & Ferketich, 2009; Koehly et al., 2009; Murthy et al., 2011).

Though few studies have specifically examined FHC communication between African American men and their health providers and families, one general study on cancer communication in underserved minority communities reported that higher income and increased cancer worry increased the likelihood that participants would talk with their family members and health providers about FHC (Kelly et al. …

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