Attitudes and beliefs about prostate cancer and screening among rural African American men.

Abstract: Purpose. The research study purpose was to describe the personal attitudes and beliefs of rural African American men related to prostate cancer and screening. Procedure. Audio taped interviews were conducted with nine (9) African American men living in rural communities of West Central Alabama. Findings. Six common themes were found among the rural African American men participants. The themes identified were: (1) Disparity; (2) Lack of understanding; (3) Tradition; (4) Mistrust in the system; (5) Fear; and (6) Threat to manhood Conclusions. The results support the general significance of understanding the views of the target population and specifically its culture and offer opportunities for adapting health promotion to the population. Key Words: Prostate Cancer, Prostate Cancer Screening, African American Men, Rural, Qualitative Research Prostate cancer is the most commonly diagnosed cancer, and the second leading cause of cancer death among men in the United States. The American Cancer Society [ACS] (2005) estimates that approximately 232,090 men will be diagnosed with prostate cancer and 30,350 will die of the disease in the year 2005. African American men are diagnosed with prostate cancer up to 65% more frequently than their Caucasian counterparts, and are more than twice as likely to die from it (ACS, 2005; Prostate Cancer Foundation, 2004). Reasons postulated for this health disparity is the lack of early diagnosis (prostate cancer screening) and treatment in African American men. One of the two major goals of Healthy People 2010 (United States Department of Health and Human Services [USDHHS], 2000) is to eliminate health disparities. To do so, a better understanding of the reasons that African American men do not avail themselves for prostate cancer screening is essential. The purpose of this study was to describe personal attitudes and beliefs of rural African American men related to prostate cancer and prostate cancer screening. BACKGROUND Prostate cancer screening is controversial relating to the lack of consensus surrounding screening recommendations (ACS, 2005; National Cancer Institute [NCI], 2005; Center for Disease Control and Prevention [CDC], 2003). Organizations such as NCI and the CDC do not advocate routine testing for prostate cancer at this time. However, the ACS, American Urological Association and the National Comprehensive Cancer Network recommend yearly prostate cancer screenings (ACS, 2005; Wilkinson, List, Sinner/Dai & Chodak, 2003). Most clinicians and researchers agree, however, that to significantly reduce prostate cancer mortality rates of at-risk male populations such as African American men and men with a family history of prostate cancer should be screened (ACS, 2005). African American men should be informed about the benefits of prostate cancer screening, including risks and benefits. Informed decisions can then be made concerning participation in prostate cancer screening. Health Disparities. Health disparity or health inequality is noted to be a difference in health status of one group of people compared to another (Smedley Stith, & Nelson, 2003). According to Woods et al. (2004) there is overwhelming evidence that African Americans and other minorities receive substandard health care compared to Caucasians across a range of health conditions and procedures when insurance status, income, age and severity of condition are comparable. A major goal of Healthy People 2010 is to eliminate health disparities, specifically related to cancer in underserved populations. Cancer is one of the 28 focus areas identified to assist in the visualization of a healthy community (U.S. Department of Health and Human Services, 2000). There is great diversity among rural African American communities, but compared to the United States population as a whole, most experience disparities in their health status. Whether it is related to physician access, transportation access, or other causes, undetected cancer and fewer visits to the physicians have been identified as being related to "differences" in the rural population (Mueller, Ortegra, Parker, Patil, Askenazi, 1999). …