Reactions to Recommendations and Evidence About Prostate Cancer Screening Among White and Black Male Veterans

Research output: Contribution to journalArticlepeer-review

Abstract

U.S. clinical guidelines recommend that prior to screening for prostate cancer with Prostate Specific Antigen (PSA), men should have an informed discussion about the potential benefits and harms of screening. Prostate cancer disproportionately affects Black men. To understand how White and Black men reacted to a draft educational pamphlet about the benefits and harms of PSA screening, we conducted race-specific focus groups at a midwestern VA medical center in 2013 and 2015. White and Black men who had been previously screened reviewed the draft pamphlet using a semistructured focus group facilitator guide. Forty-four men, ages 55–81, participated in four White and two Black focus groups. Three universal themes were: low baseline familiarity with prostate cancer, surprise and resistance to the recommendations not to test routinely, and negative emotions in response to ambiguity. Discussions of benefits and harms of screening, as well as intentions for exercising personal agency in prevention and screening, diverged between White and Black focus groups. Discussion in White groups highlighted the potential benefits of screening, minimized the harms, and emphasized personal choice in screening decisions. Participants in Black groups devoted almost no discussion to benefits, considered harms significant, and emphasized personal and collective responsibility for preventing cancer through diet, exercise, and alternative medicine. Discussion in Black groups also included the role of racism and discrimination in healthcare and medical research. These findings contribute to our understanding of how men’s varied perspectives and life experiences affect their responses to prostate cancer screening information.

Original languageEnglish (US)
JournalAmerican Journal of Men's Health
Volume15
Issue number3
DOIs
StatePublished - Jun 8 2021

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Department of Veterans Affairs Health Services Research & Development (VA HSR&D) Center of Innovation grant #HFP 98-001; VA HSR&D Research Career Scientist award #RCS 10-185 (Partin); VA HSR&D Locally Initiated Project Grant #HVC 15-1 (Danan); and the VA National Center for Health Promotion and Disease Prevention. This research was supported by the Agency for Healthcare Research and Quality (AHRQ) (K12HS026379) and Patient-Centered Outcomes Research Institute (PCORI) (K12HS026379) (Danan). The content is solely the responsibility of the authors and does not necessarily represent the official views of AHRQ, PCORI, or Minnesota Learning Health System Mentored Career Development Program (MN-LHS). Dr. Wilt received funding through a VA Undersecretary of Health Award focused on High Value Care. The views expressed in this article are those of the authors and do not necessarily represent the position or policy of the U.S. Department of Veterans Affairs or the United States Government.

Publisher Copyright:
© The Author(s) 2021.

Keywords

  • early detection of cancer
  • focus groups
  • health communication
  • prostatic neoplasms
  • veterans

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