Complexity of Prostate Cancer Diagnosis in African American Men in the United States

Complexity of Prostate Cancer Diagnosis in African American Men in the United States by Adam B. Sumlin MBA, Phoenix University, 2007 BS, Fisk University, 1976 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University February 2016 Abstract Researchers have identified higher incidence rates and mortality rates among African American men (AAM) diagnosed with prostate cancer than they have among urban African American men. This quantitative descriptive study was conducted to measure the association between advanced stage and grade of prostate cancer, demographic location, and prostate specific antigen (PSA) levels over a 5-year period in AAM and European American men (EAM) in rural versus urban communities. This study addressed 4 research questions concerning cancer grade, cancer stage, age, geographic location, PSA level, and the impact that each of these variables had on prostate cancer diagnosis in AAM in the United States. Social cognitive theory was used as a conceptual framework, which was to focus on AAM, and their behavior with prostate cancer diagnosis, in rural versus urban communities. The sample was derived from data collected from the Surveillance, Epidemiology, and End Results Program (SEER) database. The population sample size was greater than 20,000. These data were categorically analyzed using a Chisquare test and a t test. Overall, the results of the study showed that there was a statistical difference in rural versus urban populations between AAM and EAM diagnosed with prostate cancer over a 5-year period, and when comparing AAM with EAM in urban versus rural communities over a 5 year period, there was a significant difference in men diagnosed with prostate cancers as well as a significant change among men annually diagnosed with advanced stage prostate cancer. Information provided may have implications for positive social change affecting both rural and urban AAM in reducing fear and promoting prostate cancer awareness. This awareness may reduce advanced stage or grade diagnosis in AAM in both rural and urban communities.Researchers have identified higher incidence rates and mortality rates among African American men (AAM) diagnosed with prostate cancer than they have among urban African American men. This quantitative descriptive study was conducted to measure the association between advanced stage and grade of prostate cancer, demographic location, and prostate specific antigen (PSA) levels over a 5-year period in AAM and European American men (EAM) in rural versus urban communities. This study addressed 4 research questions concerning cancer grade, cancer stage, age, geographic location, PSA level, and the impact that each of these variables had on prostate cancer diagnosis in AAM in the United States. Social cognitive theory was used as a conceptual framework, which was to focus on AAM, and their behavior with prostate cancer diagnosis, in rural versus urban communities. The sample was derived from data collected from the Surveillance, Epidemiology, and End Results Program (SEER) database. The population sample size was greater than 20,000. These data were categorically analyzed using a Chisquare test and a t test. Overall, the results of the study showed that there was a statistical difference in rural versus urban populations between AAM and EAM diagnosed with prostate cancer over a 5-year period, and when comparing AAM with EAM in urban versus rural communities over a 5 year period, there was a significant difference in men diagnosed with prostate cancers as well as a significant change among men annually diagnosed with advanced stage prostate cancer. Information provided may have implications for positive social change affecting both rural and urban AAM in reducing fear and promoting prostate cancer awareness. This awareness may reduce advanced stage or grade diagnosis in AAM in both rural and urban communities. Complexity of Prostate Cancer Diagnosis in African American Men in the United States by Adam B. Sumlin MBA, Phoenix University, 2007 BS, Fisk University, 1976 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University February 2016 Dedication First and foremost, all praise and honor go to my Creator of the Universe for giving me the ability to continue my education to this degree. I want to dedicate this thesis to my mother, who passed away during my sophomore year of undergraduate studies. She was the motivating factor that kept me wanting to learn because of her persistent ways of making sure I completed my education in order to advance in life. I also want to dedicate this to my loving wife, Denice, who stood by me the entire time I was working on this degree, and whose understanding that I was driven to complete this process caused her to sacrifice while I continued my education. I love you for this and will always be by your side for hanging in there with me during this long and tedious process. Acknowledgments I would like to give special thanks to Dr. Raymond Panas for his patience and guidance, along with his timely responses during this process; you are an inspiration for all who are under your tutelage. Dr. Amy Thompson, you have been a lifesaver during this process; I could not have gotten this far if you had not come onto my committee, thank you so much. I want to also thank you for your knowledge of prostate cancer; this was the added encouragement that kept me focused. Sincere thanks are given to Dr. Willie Underwood; you kept me focused on why I was studying African American men and prostate cancer. Your knowledge and ability to keep me in the loop helped me tremendously, and I will never forget you. Dr. William Burhan, for reviewing my writing and lending an ear to my findings, I greatly appreciated your guidance and thank you for being the person you are.