“Our people has got to come to terms with that”: changing perceptions of the digital rectal examination as a barrier to prostate cancer diagnosis in African‐Caribbean men

Abstract

Objective African‐Caribbean men in the United Kingdom in comparison with other ethnicities have the highest incidence rate of prostate cancer. Psychosocial aspects related to screening and presentation impact on men's behavior, with previous studies indicating a range of barriers. This study explores one such barrier, the digital rectal examination (DRE), due to its prominence within UK African‐Caribbean men's accounts. Methods African‐Caribbean men with prostate cancer (n = 10) and without cancer (n = 10) were interviewed about their perceptions of DRE. A synthetic discursive approach was employed to analyze the data. Results Findings illustrate that an interpretative repertoire of homophobia in relation to the DRE is constructed as having an impact upon African‐Caribbean men's uptake of prostate cancer screening. However, the discursive focus on footing and accountability highlight deviations from this repertoire that are built up as pragmatic and orient to changing perceptions within the community. Conclusions Health promotion interventions need to address the fear of homophobia and are best designed in collaboration with the community.

Initial experience of a community‐based prostate cancer risk assessment clinic for men of black and minority ethnicity background

“…There is an assumption that BME men are opposed to rectal examination . We did not find this to be an issue, however, as, of the 312 attendees, only 6 (<2%) declined DRE.…”

“…There is an assumption that BME men are opposed to rectal examination. 15 We did not find this to be an issue, however, as, of the 312 attendees, only 6 (<2%) declined DRE. It was our experience that once the purpose of the examination was clearly explained and understood, men were willing to consent as part of their assessment.…”

Tackling inequalities in cancer care and outcomes: psychosocial mechanisms and targets for change

“…Over 50 papers were submitted to the call for this issue (the most for any Psycho‐Oncology special issue to date), and 148 reviewers based in 14 different countries have been involved in peer‐reviewing the submissions. Sixteen of the submissions are included in this special issue: 3 literature reviews, 9 research papers, and 3 clinical correspondence pieces, as well as a report from the International Federation of Psycho‐Oncology Societies which documents and highlights the heterogeneity of the federated societies and the global between‐country differences in the development and implementation of psycho‐oncology care …”

“…Collectively, the papers in this special issue use a wide range of methodologies and analytic techniques with a diverse range of samples, to look at disparities in cancer care and outcomes at several points on the cancer continuum: from screening, to symptom attribution, to diagnosis, treatment and care, and into survivorship, in relation to a number of different factors: chiefly education, ethnicity, and cultural factors (such as religious beliefs and English language proficiency) and the presence of comorbid health conditions but also residential location, age, and relationship status . For example, Ruiz and colleagues examine differences in smoking, alcohol, and drug use on the basis of age and ethnicity among adolescent and young adult survivors of childhood cancer, who remain at risk for poor long‐term health outcomes.…”

“…For example, research in many countries consistently finds an elevated incidence of prostate cancer among men of African descent, and there is strong evidence of a disproportionately high breast cancer mortality rate in African American women, even after accounting for socioeconomic status . Nine of the papers in this issue seek to enhance our understanding of ethnic and cultural cancer disparities . For instance, Seymour‐Smith and colleagues elucidate reasons for the low uptake of digital rectal examination screening for prostate cancer among UK African‐Caribbean men.…”