Psychosocial factors influencing doctor visits and prostate cancer screening among men

Prostate cancer is the most common type of cancer found among men, besides skin cancer. This study examined psychological, social, and cultural factors that influence that influence whether they see a doctor and decisions about prostate cancer screening. A participatory research approach was used. Qualitative focus group data were collected on a sample of volunteer participants (N=74) who were including African American men (76%) and white men (24%) ages 40-70 in Nashville, Tennessee. A key issue identified by men was their (lack of) willingness to go to the doctor for any reason (for illness or prevention), since consideration of screening options is irrelevant if men do not even visit a doctor. Masculinity and gender socialization shaped men's attitudes about and decisions to seek medical care in general. Men revealed a lack of knowledge or inaccurate knowledge about screening options, and expressed interest in more media attention to men's health issues. Many expressed acceptance or a neutral attitude about the PSA blood test, while very strong emotions were expressed regarding the digital rectal exam (DRE). In addition to concerns about pain or discomfort, several issues related to masculinity and sexuality were expressed regarding the DRE – including concerns about privacy and embarrassment, sexual function and manhood, and homophobia. The quality and content of interaction with the doctor also influenced men's screening decisions. Results from this study were used to construct questionnaire items for a survey of men. The findings will be used to improve or design new community outreach programs.