Psychosocial Contribution of Masculinity and Sense of Mastery to Prostate Cancer Screening Among African American Men

Despite recent prostate cancer screening controversy, most physicians agree that early detection is especially important among at-risk groups of men. African American men bear the heaviest prostate cancer burden in North Carolina and are screened less often than White men. Qualitative examinations link sense of mastery and male norms, which emphasize healthcare avoidance, to screening delays among men. Quantitative studies scarcely document these relationships among African American men. We employed the Andersen Behavioral Model and The Theory of Reasoned Action to investigate the direct and interactive contributions of male norms and sense of mastery to prostate cancer screening. Two-hundred fifteen men recruited at baseline for the NC MAN for Health intervention completed measures assessing demographics, healthcare access, physical health status, male norms, and sense of mastery. Outcomes were self-reported Prostate Specific Antigen (PSA) and Digital Rectal Exam (DRE) screenings. After adjustment, men with more male norms endorsement were significantly less likely to report DRE (O.R. = 0.35; 95% C.I. = 0.13, 0.92) PSA screening (O.R. = 0.36; 95% C.I. = 0.13; 1.00). Male norms interacted with sense of mastery to differentially impact the odds of PSA testing. Specifically, in the absence of sense of mastery, male norms decreased, but did not have a statistically significantly effect on, the odds of PSA screening. In the presence of sense of mastery, male norms significantly increased the odds of obtaining a PSA test. Findings suggest that sense of mastery counterbalances the negative effects of male norms on PSA screening among African American men.