Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #110886

Carmen E. Guerra, MD, Division of General Internal Medicine, University of Pennsylvania, 1221 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, (215) 662-7624, carmen.guerra@uphs.upenn.edu, Samantha E. Jacobs, School of Medicine, University of Pennsylvania, Stemmler Hall, 3450 Hamilton Walk, Philadelphia, PA 19104, Judy A. Shea, PhD, Division of General Internal Medicine, Univeristy of Pennsylvania, Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, Elizabeth A. Ellis Ohr, Center for Clinical Epidemiology and Biostatistics, Univeristy of Pennsylvania, 723 Blockley Hall, 423 Guardian Drice, Philadelphia, PA 19104, Robert Hornik, Annenberg School for Communication, University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA 19104, Dominick Frosch, PhD, Annenberg School of Communications, University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA 19104, and John H. Holmes, PhD, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, School of Medicine, Philadelphia, PA 19104.

The disparity in prostate cancer (PC) incidence and mortality between African American (AA) and white men is well recognized. This study explored physicians' perception of how race and educational level affect prostate cancer screening (PCS) discussions. Qualitative study involving in-depth, semi-structured interviews with 17 purposively-sampled, community and academic based primary care physicians. Analysis was performed using consensus conferences. Most physicians were aware of the PC disparity. Physicians say they are more likely to raise PCS, intend to have a persuasive discussion with AA men, and to screen more and younger AA men. The quality of discussion was affected by education, regardless of race, although these are associated. Physicians perceive highly educated patients as more aware and likely to request PSAs, more likely to ask questions, and to understand benefits and limitations of PSAs. Low educated patients are perceived as requiring more discussion time, as less likely to ask questions, and more likely to ask the physician to make the decision for them. These lead to default ordering of a PSA. Physicians found it difficult to explain PSAs to less educated men. Strategies used with low educated patients include using simpler terminology, slower speech, and providing less detail. Physicians recognize racial disparities and aim to discuss PCS with and screen more AA men. Still they report less robust discussions with low educated patients who are more often AA. Future interventions include teaching physicians and low educated patients how to effectively communicate with one another about PCS.

Learning Objectives:

• At the conclusion of the session, the participant will be able to identify the racial and educational barriers to prostate cancer screening discussion between physician and patient.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.