How African American Men Decide Whether or Not to Get Prostate Cancer Screening

Randy A. Jones, PhD, RN; Richard Steeves, PhD, RN, FAAN; Ishan Williams, PhD


Cancer Nurs. 2009;32(2):166-172. 

In This Article

Abstract and Introduction


Prostate cancer is the most commonly diagnosed cancer in men in the United States and affects African Americans disproportionately when compared to other ethnic groups. There are unclear reasons for this disparity, but several factors may include race, nutrition, family history of cancer, and screening. With early detection of prostate cancer, survival is much better; thus, screening may be helpful, especially for high-risk individuals. Prostate cancer screening continues to be controversial. A paucity of data exists on what prostate cancer screening means to African Americans, particularly in rural areas, and how they make the decision whether or not to undergo prostate cancer screening. This study interviewed 17 African American men to explore how and when they decided about prostate cancer screening. Most of the men (n = 9) said that they had prostate cancer screening. Three themes emerged from the data: (1) these men had information on prostate cancer; (2) family and friends played an important role in the men's decision-making process; and (3) for screening, it was necessary for the men to have a trusting relationship with their healthcare provider. These findings confirm that the decision-making process is not a simple process. The study's results can help healthcare providers understand some of the important decision-making factors in prostate cancer screening for African American men.


Prostate cancer is the most commonly diagnosed cancer in men and the second leading cause of cancer deaths among men in the United States, after lung cancer. The American Cancer Society[1] has estimated that 186,320 men in the United States will be newly diagnosed with prostate cancer in the United States during 2008, and the cancer will kill 28,660 men. Prostate cancer affects African American men disproportionately; they have the highest incidence of prostate cancer at 248.5 cases per 100,000 compared to 156.7 cases per 100,000 white men and 138.0 cases per 100,000 Hispanic men.[2] African Americans are also more likely to be diagnosed with a neoplasm that has spread beyond the immediate adjacent organs or tissues and have tumors metastasized to distant lymph nodes.

The US Preventive Services Task Force has concluded that the evidence is insufficient to recommend for or against routine screening for prostate cancer. Although screening has not been shown to directly decrease mortality, it offers the only possibility for early detection of prostate cancer. Early detection is particularly important for high-risk individuals such as African Americans and individuals with a first-degree relative (ie, father, brother) who have had prostate cancer.


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