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

Potential Explanations for Increased Prostate Cancer Risk in African Americans

Reasons for increased prostate cancer mortality among African American men are unclear. Individuals, particularly African Americans, who have limited finances and education are likely to be unable to obtain and pay for adequate healthcare services, which may increase mortality risk.[3,4,5,6,7] In addition, many African Americans distrust healthcare providers because of unequal healthcare access and experiences[8] and past research such as the Tuskegee syphilis study in which African American men with syphilis were denied treatment.[9] Numerous organizations and agencies including the US Department of Health and Human Services have reported that minority groups are less likely than whites to seek preventive care or make return medical visits.[10] Yet, one of the most significant potential risk factors for African Americans with chronic illnesses such as cancer may be due to their cultural beliefs.

Several studies have found that African Americans who are high in cultural mistrust tend to have more negative views and expectations of white healthcare providers than others who see the same healthcare providers.[11,12,13,14] For instance, Sussman and colleagues[14] conducted a psychiatric epidemiologic survey of 3,004 households to determine differences among African Americans and white Americans in their determination to seek treatment of depression and to identify the groups that were least likely to seek care. The investigators found that African Americans were less likely to seek professional healthcare, even when there was little evidence that fear of being stigmatized prevented health-seeking behaviors. This study found that African Americans were more likely to seek informal health advice from family members, friends, community centers, and churches. African Americans, like other minority groups, sometimes do not feel comfortable speaking with healthcare providers who do not "look like them."[15] African Americans' low participation in prostate cancer screenings and screenings in general may be related to feelings of distrust and fear in the African American community. Eisler and Hersen[13] suggest therefore that to increase health-seeking behaviors among African Americans, more attention needs to be paid to cultural differences and public agencies need to try to develop an atmosphere more open to diversity.


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