Prostate cancer knowledge in African American men following physician consultations: Am I clear on what the doctor ordered?

Background: African-American (AA) men are 40% more likely to be diagnosed with prostate cancer (PCa) and twice as likely to die from the disease as Caucasian men. Biological and socioeconomic determinants contribute to this disparity.  In light of previous recommendations that overall discouraged screening, AA patient’s understanding of PCa in terms of screening, disease stages, and therapeutic options is critical in reducing these disparities.  Studies indicate that PCa knowledge strongly influences informed decisions.  Likewise, shared decision making—involving clinician-patient discussion about screening decisions—is espoused by national guidelines. This study assesses knowledge of PCa in a cohort of AA men, in light of clinical provider interactions.

Methodology: 500+ AA men in New York and California answered questions about their PCa knowledge. Bi-and multivariate analyses explored factors associated with differences in knowledge scores.

Results: Mean knowledge scores were moderate (M=7.989) and men who discussed PCa with their physicians did not score higher in PCa knowledge than those who did not.  Greater knowledge was associated with higher income and education.  Men with lower incomes and lacking health insurance were less likely to speak with a physician about PCa. Men ages 40-55 were equally likely to have spoken with a physician.

Conclusions: Many men did not discuss PCa testing with their provider, and the knowledge of those who did was not different from their peers.  Therefore, given persistent PCa disparities, it is critical to understand how to foster screening decision-making conversations, and to do so effectively, between AA men and their physicians.