Talking About Your Prostate: Perspectives from Providers and Community Members

Abstract

Prostate cancer (PrCA) screening is controversial, especially for African-American (AA) men who have higher PrCA incidence and mortality than other racial/ethnic groups. Patient-provider communication is important for the PrCA screening decision process. The study purpose was to better understand the current dialogue between primary care providers (PCPs—physicians and nurse practitioners) and AA men about PrCA prevention and screening. An online survey with 46 PCPs, education sessions (including pre/post surveys) with 56 AA men, and a forum with 5 panelists and 38 AA men for open dialogue were held to examine both provider and community perspectives on PrCA communication needs and practices. PCPs’ perceptions of PrCA screening were varied and they used different PrCA screening guidelines in their practices. PCPs and AA men had different experiences with PrCA communication. PCPs reported that they have discussions about PrCA screening and prostate health with AA patients; few AA men reported these same experiences. About 38.0% of PCPs reported that they remain neutral about PSA testing during discussions; however, only 10.7% of AA men reported that their doctor remained neutral. Prostate health knowledge among AA men increased significantly following participation in the education sessions (p < 0.001). AA community members reported high satisfaction regarding the education session and forum. Different recommendations from PCPs may hinder AA men’s decisions about PrCA screening. The forum used in this study could be a model for others to help improve patient-provider communication and increase engagement in dialogue about this common cancer.

An Exploration of Precancer and Post-Cancer Diagnosis and Health Communication Among African American Prostate Cancer Survivors and Their Families

“…The study of cancer communication among prostate cancer survivors has focused heavily on communication between the physician and the patient to identify barriers to prostate cancer screenings and prostate cancer knowledge (Choi et al, 2018;Pedersen et al, 2012;Woods-Burnham et al, 2018). Studies indicated minimal health communication regarding cancer and sexual function occurred among Black families (Friedman et al, 2012;Hovick et al, 2015;Thompson et al, 2015) due to lack of connection or closeness between family members, fear of gossip, stigmatization, and traditional views of health being a private topic (Bowen et al, 2017;Hovick et al, 2015;Thompson et al, 2015;.…”

Predictors of annual prostate-specific antigen (PSA) screening among black men: results from an urban community-based prostate cancer screening program

“…Primary healthcare providers are the foremost cancer information resources for Black men [19][20][21][22]. Patient-provider communication about PSA screening is positively associated with PSA uptake.…”

Multilevel Small Area Estimation of Prostate-Specific Antigen Screening Test in the United States by Age Group: 2018 Behavioral Risk Factor Surveillance System

“…The wide difference in the prevalence of screening among other states in the United States might also indicate the role providers' practice plays in the high prevalence of screening. Differences in provider types across geographic areas and urban and rural communities, 33 in organizations that most frequently influence providers' practices, 34,35 and in patients' preferences could contribute to varying screening use.…”