African Americans’ Perceptions of Prostate-Specific Antigen Prostate Cancer Screening

Abstract

Background In 2012, the US Preventive Services Task Force (USPSTF) released a hotly-debated recommendation against prostate-specific antigen (PSA) testing for all men. The present research examines African Americans’ beliefs about their susceptibility to prostate cancer (PCa) and the effectiveness of PSA testing in the context of the controversy surrounding this recommendation. Methods This study used a qualitative design to examine perceptions regarding susceptibility along with screening and facilitators of and barriers thereof. Data were collected at a community health center and three predominantly African American churches in North Carolina. Study participants were 46 African American men and women who attended one of four “listening sessions” for pretesting PCa educational materials (average age: 55 years). One-and-a-half-hour listening sessions were conducted to pretest materials; while presenting the materials, researchers probed beliefs and knowledge about PCa screening. The sessions were recorded and transcribed, and the transcripts were qualitatively analyzed using grounded theory. Results The four emergent themes indicated that participants: (1) cited behavioral, psychosocial, and biological reasons why African American men have higher PCa risk compared to others; (2) knew about the controversy and had varying responses and intentions; (3) believed screening could save lives, so it should be utilized regardless of the 2012 recommendation; and (4) felt that women can help men go to the doctor and make screening decisions. Conclusions Health education efforts to help community members understand health controversies, screening options, and how to make informed screening decisions are critical.

A qualitative meta‐synthesis examining the role of women in African American men's prostate cancer screening and treatment decision making

“…Along with purposive sampling, Jones and colleagues also used “snowball” sampling. Four studies recruited participants from medical centers, 5 studies recruited participants from the community, and 1 study recruited participants from both community and medical sites.…”

“…Sample size in studies ranged from 14 to 81 participants. Most studies obtained data directly from participants through semistructured interviews or focus group discussions . Owens and colleagues included additional survey data collected prior to and following education sessions.…”

Prostate Cancer Ambassadors: Enhancing a Theory-Informed Training Program for Informed Decision-Making

“…The SCT and ALT were used throughout the process. Recognizing the role of women was an important contribution to the curriculum since they are viewed as key conduits for getting information to their husbands and other family members [15]. Further, the team provided the ambassadors with a multimodal toolkit containing teaching tools that are appropriate for different types of presentations: a wallet card for one-on-one conversations, a table-top flip chart for small group discussions, and a set of slides for larger presentations.…”

“…For one, the curriculum acknowledged the role of women in helping their loved ones make decisions about prostate health by making the training material inclusive along with the provision of practical skills training for being a female ambassador. This addition followed a lesson learned from formative work, in which focus group participants identified women as important vehicles for helping convince the men in their lives to go to the doctor and care for their health [15]. The curriculum trained individuals to identify the limitations of PSA screening and then provided them with guidance for speaking with others in their community about the informed decision-making process without pressuring those community members to make a specific or predefined choice.…”

What's new in screening in 2015?

“…[77–80] Two survey studies showed that there was awareness on the screening controversy yet the majority of men still believed that screening saved lives and should be used despite the USPSTF recommendation. [81, 82] Jemal et al examined the recent changes in stage specific incidence and PSA testing rates. The authors used SEER data on invasive PC incidence data from 2005 to 2012 and had the availability of 2013 incidence data from one registry (Georgia).…”