A Comparitive Study of Prostate Screening Health Beliefs and Practices between African American and Caucasian Men
Lambert, Sharon, Fearing, Arleen, Bell, Doris, Newton, Marguerite, ABNF Journal
Abstract: This descriptive comparative study investigated the prostate screening health beliefs and practices of men over the age of 45. A self-administered questionnaire was used prior to an informational session, which also included a question and answer period, as needed, and handout materials donated by the American Cancer Society on risk factors, screening tests and early detection of prostate cancer. The study results showed that there were no significant differences between African American and Caucasian men on age, self-reported health status and the utilization of a private physician for their health care. Both groups had similar history of blood relatives with cancer, and concern about development of illness. More Caucasian men had the digital rectal exam (DRE) done while African American males had the prostate-specific antigen (PSA) done more often; however, 26% of the entire sample indicated they had never had the screening test done. Group comparisons revealed a significant difference between the groups on the belief that faith contributes to health which was greater for the African Americans, while the Caucasian men had a greater belief that they were likely to develop prostate cancer. Results of this study indicate that there are still a significant number of men reporting never having had a PSA test done even though 75% knew that the test is recommended for early detection of prostate cancer. Continued efforts to educate and increase screening are still needed among both African American and Caucasian men.
Key Words: African American Men, Caucasian Men, Prostate Cancer, Prostate Cancer Screening, Health Practices
Surveillance research by the American Cancer Society (2002a) estimates that 189,000 new cases of prostate cancer will be detected and 30,200 deaths from prostate cancer will occur in the United States during the year 2002. These figures are less than the 2001 estimates; however, in general, this is a high number of cases even though screening tests are available to aid in earlier detection of the disease. Prostate cancer incidence and mortality rates also continue to be higher for African American males than any other ethnic group and remains the second leading cause of death in all male adults. Since early detection of prostate cancer continues to indicate a higher 5-year relative survival rate, screening is still recommended. The American Cancer Society recommends screening at age 50 with the exceptions of all men at higher risk and African American men in which screening should then start at age 45. Recommendations also include patient instruction on screening to facilitate informed decision making. (American Cancer Society, 2002b).
The purpose of this descriptive comparative study was to investigate the prostate screening health beliefs and practices of men over the age of 45. A comparison between the African American and Caucasian participants' responses were included to describe similarities and differences which could be beneficial in developing future community education programs specific to their health promotion needs.
The conceptual framework used for the study was Pender's Health Promotion Model which stipulates a relationship between personal perceived health variables and actual health promoting behaviors (Pender, 1997). In relation to this study, the goal was to empower the men to make their personal decision to participate in the health promoting behavior of annual prostate screening based on current information.
REVIEW OF THE LITERATURE
Current studies in the health related literature reveal that prostate cancer screening continues to be recommended and is increasingly utilized in the United States even though testing remains controversial (American Cancer Society, 2002b; Cohen & Jaskulsky, 2001 and Albertsen, 1997). The controversy related to prostate cancer screening centers around the issues of mass screening, limitations of the screening tests and lack of evidence showing definite benefit from the screening (National Cancer Institute, 2000; Gambert, 2001; Steele, et al. …