Factors influencing prostate cancer treatment decisions for African-American and White Men

RESEARCH OBJECTIVE: The death rate for prostate cancer (PrCA), the most commonly diagnosed cancer in African-American (AA) men, is twice the rate of white men. AA men in South Carolina have the highest age-adjusted death in the nation. Studies have shown that treatment offered to AA men with PrCA is systematically different from that offered to white men. STUDY DESIGN: Surveys were mailed to 1,866 men in South Carolina with a diagnosis of PrCA. We performed a descriptive assessment of the factors that influenced PrCA treatment decisions. POPULATION STUDIED: South Carolina men diagnosed with PrCA between 1996 and 2002 were eligible to participate. PRINCIPAL FINDINGS: African-American men were more likely to undergo aggressive treatments compared to their white counterparts. The treatment choices of AA men were significantly more likely to be influenced by pain and significantly less likely to be influenced by potential for cure compared to white men. African-American men were also significantly more likely to live without a wife or partner, were more likely to live alone, were younger (68 vs 72) and were significantly more likely to have difficulty attending doctor appointments than white men. CONCLUSIONS: African-American men were less likely to report cure and more likely to report pain avoidance as an influence of treatment decisions. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Providers must be cognizant of the factors that influence treatment in AA men. Federal health agendas should include a specific focus on the health of AA men.