1
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Morrison BF, Gordon Y. Does a family history of prostate cancer affect screening behavior in Jamaican men? Rev Panam Salud Publica 2019; 42:e143. [PMID: 31093171 PMCID: PMC6385629 DOI: 10.26633/rpsp.2018.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 06/09/2018] [Indexed: 11/24/2022] Open
Abstract
Objective To determine 1) the characteristics of males with a family history of prostate cancer who presented for screening and 2) the association between family history and diagnosis of prostate cancer in a cohort of screened Jamaican men. Methods The study consisted of a prospective cohort of black men who screened at the Jamaica Cancer Society in Kingston between 2006 and 2016. Data were collected on: 1) age at screening and age at diagnosis of prostate cancer, 2) family history of prostate cancer, and 3) prostate-specific antigen (PSA) and digital rectal examination (DRE) findings. Results Approximately 600 (21.4%) of screened men who reported data on family history (2 791 / 2 867) said they had a family history of prostate cancer. Men with a family history of prostate cancer 1) commenced screening at a younger age than men without a family history (P <0.001) and 2) tended to have a younger age at diagnosis of prostate cancer (P = 0.262). There was no significantly increased risk of prostate cancer in men with a reported family history of prostate cancer (odds ratio: 1.4; 95% confidence interval: 0.821–2.386; P = 0.217). Conclusions Men with a family history of prostate cancer presented frequently for screening and earlier than those without. There was a lack of association between family history of prostate cancer and diagnosis. Further studies are needed to investigate this association and validate family histories.
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Affiliation(s)
- Belinda F Morrison
- Department of Surgery, University of the West Indies-Mona, Kingston, Jamaica
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2
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Gordon BBE, Basak R, Carpenter WR, Usinger D, Godley PA, Chen RC. Factors influencing prostate cancer treatment decisions for African American and white men. Cancer 2019; 125:1693-1700. [PMID: 30695113 PMCID: PMC6604809 DOI: 10.1002/cncr.31932] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/13/2018] [Accepted: 11/16/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Prostate cancer racial disparities in mortality outcomes are the largest in all of oncology, and less aggressive treatment received by African American (AA) patients versus white patients is likely a contributing factor. However, the reasons underlying the differences in treatment are unclear. METHODS This study examined a prospective, population-based cohort of 1170 men with newly diagnosed nonmetastatic prostate cancer enrolled from 2011 to 2013 before treatment throughout North Carolina. By phone survey, each participant was asked to rate the aggressiveness of his cancer, and his response was compared to the actual diagnosis based on a medical record review. Participants were also asked to rate the importance of 10 factors for their treatment decision-making process. RESULTS Among AA and white patients with low-risk cancer (according to National Comprehensive Cancer Network guidelines), 78% to 80% perceived their cancers to be "not very aggressive." However, among high-risk patients, 54% of AA patients considered their cancers to be "not very aggressive," whereas 24% of white patients did (P < .001). Although both AA and white patients indicated that a cure was a very important decision-making factor, AAs were significantly more likely to consider cost, treatment time, and recovery time as very important. In a multivariable analysis, perceived cancer aggressiveness and cure as the most important factor were significantly associated with receiving any aggressive treatment and were associated with surgery (vs radiation). After adjustments for these factors and sociodemographic factors, race was not significantly associated with the treatment received. CONCLUSIONS Racial differences in perceived cancer aggressiveness and factors important in treatment decision making provide novel insights into reasons for the known racial disparities in prostate cancer as well as potential targets for interventions to reduce these disparities.
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Affiliation(s)
| | - Ramsankar Basak
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - William R Carpenter
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina.,Department of Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Deborah Usinger
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina
| | - Paul A Godley
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina.,Division of Hematology/Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ronald C Chen
- University of North Carolina School of Medicine, Chapel Hill, North Carolina.,Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina.,University of North Carolina Cecil G. Sheps Center for Health Services Research, Chapel Hill, North Carolina
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3
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Allen JD, Akinyemi IC, Reich A, Fleary S, Tendulkar S, Lamour N. African American Women's Involvement in Promoting Informed Decision-Making for Prostate Cancer Screening Among Their Partners/Spouses. Am J Mens Health 2018; 12:884-893. [PMID: 29298558 PMCID: PMC6131450 DOI: 10.1177/1557988317742257] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 09/21/2017] [Accepted: 09/25/2017] [Indexed: 12/13/2022] Open
Abstract
Routine prostate cancer screening is not recommended but African American men who are at higher risk for the disease should be offered the opportunity for shared decision-making with their health-care providers. This qualitative study sought to better understand the potential role of women in educating their male spouses/partners about prostate cancer screening. Nine focus groups were conducted ( n = 52). Women were recruited from a variety of community venues. Those eligible were African American and married to or in a partnership with an African American male age ≥ 45. Women provide numerous types of support to their male partners in an effort to facilitate participation in preventive health care. While women agreed that they would like to educate their partners about prostate cancer screening, they had little information about screening guidelines or the potential harms and limitations. The current findings suggest that women are eager information-seekers and can disseminate information to men and facilitate their efforts to make more informed decisions about prostate cancer screening. Women should be included in educational interventions for to promote informed decision-making for prostate cancer screening.
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Affiliation(s)
- Jennifer D. Allen
- Department of Community Health Tufts
University, Medford, MA, USA
- Department of Community Health Tufts
University, Medford, MA, USA
| | - Ifedayo C. Akinyemi
- Department of Public Health and Community
Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Amanda Reich
- Department of Public Health and Community
Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Sasha Fleary
- Eliot-Pearson Department of Child Study and
Human Development, Tufts University, Medford, MA, USA
| | | | - Nadeerah Lamour
- Department of Community Health Tufts
University, Medford, MA, USA
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4
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Mutua K, Pertet AM, Otieno C. Cultural factors associated with the intent to be screened for prostate cancer among adult men in a rural Kenyan community. BMC Public Health 2017; 17:894. [PMID: 29169333 PMCID: PMC5701294 DOI: 10.1186/s12889-017-4897-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 11/07/2017] [Indexed: 01/08/2023] Open
Abstract
Background The aim of this study was to determine cultural factors associated with prostate cancer screening intent among adult Kenyan African men. Methods A cross-sectional quantitative study with an analytic design was carried out in a randomly selected sample of 155 adult men aged 25–98 years living in a rural community in Kenya. Constructs from the Theory of Planned Behaviour were used to guide this study. A 5 -point Likert scale was used to assess fatalistic beliefs, fear, perceived benefits, and family influence. A structured questionnaire was used to collect quantitative data at the household level. Results Only 2.4% of the study participants had been screened for prostate cancer. About 2/3rd (64%) of the participants felt that they were at risk of getting prostate cancer; 44% intended to be screened within the following 6 months. Mean scores on a 5-point Likert scale indicated: strong beliefs in the benefits of prostate screening (4.2 (±SD .8), men aged over 40 were not perceived to be at risk of getting prostate cancer (1.3 ± .6), relatively high fatalistic beliefs of prostate cancer screening (3.6 (±SD .8), high degree of fear or apprehension of prostate cancer screening (3.2 (±SD 1.2), and a high level of influence of family members in prostate cancer screening (3.9 (±SD 1.0). The Wald criterion demonstrated that only family influence made a significant contribution to the intent to screen for prostate cancer (p = 0.031). Age, education, marital status, fatalism, fear, and benefit of screening were not associated with the intent to screen for prostate cancer. Conclusions Strong beliefs of the benefits of prostate screening tended to be surpassed by relatively high fatalistic beliefs and fear or apprehension in prostate cancer screening. The family plays an important role in influencing decision making related to prostate cancer screening in Africans.
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Affiliation(s)
- Kinyao Mutua
- Kenya Medical Training Institute, P.O Box 260, Sultan Hamud, Kenya.,Kenya Medical Training College, Machakos, Kenya
| | - Anne M Pertet
- Great Lakes University of Kisumu (Gluk), P. O. Box: 2224-40100, Kisumu, Kenya.
| | - Careena Otieno
- Great Lakes University of Kisumu (Gluk), P. O. Box: 2224-40100, Kisumu, Kenya
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5
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Leapman M, Jazayeri SB, Katsigeorgis M, Hobbs A, Samadi DB. Patient-perceived Causes of Prostate Cancer: Result of an Internet-based Survey. Urology 2017; 99:69-75. [DOI: 10.1016/j.urology.2016.09.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 08/31/2016] [Accepted: 09/03/2016] [Indexed: 11/15/2022]
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6
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de Melo-Martín I. How best to protect the vital interests of donor-conceived individuals: prohibiting or mandating anonymity in gamete donations? REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2016; 3:100-108. [PMID: 29774255 PMCID: PMC5952682 DOI: 10.1016/j.rbms.2017.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 11/02/2016] [Accepted: 01/30/2017] [Indexed: 05/12/2023]
Abstract
Anonymous gamete donation continues to be practised in most jurisdictions around the world, but this practice has come under increased scrutiny. Thus, several countries now mandate that donors be identifiable to their genetic offspring. Critics contend that anonymous gamete donation harms the interests of donor-conceived individuals and that protection of these interests calls for legal prohibition of anonymous donations. Among the vital interests that critics claim are thwarted by anonymous donation are an interest in having a strong family relationship, health interests, and an interest in forming a healthy identity. This article discusses each of these interests and examines what they could involve. The legislation in two countries is considered: Spain, which mandates anonymous gamete donation, and the UK, which prohibits such practice, to assess how these different legislations might or might not protect these vital interests.
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7
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de Melo-Martín I. Lack of Access to Genetic-Relative Family Health History: A Health Disparity for Adoptees? THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2016; 16:43-45. [PMID: 27901436 DOI: 10.1080/15265161.2016.1240257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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8
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Ahaghotu C, Tyler R, Sartor O. African American Participation in Oncology Clinical Trials--Focus on Prostate Cancer: Implications, Barriers, and Potential Solutions. Clin Genitourin Cancer 2015; 14:105-16. [PMID: 26786562 DOI: 10.1016/j.clgc.2015.12.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 12/09/2015] [Accepted: 12/09/2015] [Indexed: 12/17/2022]
Abstract
In the United States, the incidence and mortality rates of many cancers, especially prostate cancer, are disproportionately high among African American men compared with Caucasian men. Recently, mortality rates for prostate cancer have declined more rapidly in African American versus Caucasian men, but prostate cancer is still the most common cancer and the second leading cause of cancer deaths in African American men in the United States. Compared with Caucasian men, prostate cancer occurs at younger ages, has a higher stage at diagnosis, and is more likely to progress after definitive treatments in African American men. Reasons for racial discrepancies in cancer are multifactorial and potentially include socioeconomic, cultural, nutritional, and biologic elements. In addition to improving access to novel therapies, clinical trial participation is essential to adequately establish the risks and benefits of treatments in African American populations. Considering the disproportionately high mortality rates noted in these groups, our understanding of the natural history and responses to therapies is limited. This review will explore African American underrepresentation in clinical trials with a focus on prostate cancer, and potentially effective strategies to engage African American communities in prostate cancer research. Solutions targeting physicians, investigators, the community, and health care systems are identified. Improvement of African American participation in prostate cancer clinical trials will benefit all stakeholders.
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Affiliation(s)
- Chiledum Ahaghotu
- Department of Urology, College of Medicine, Howard University, Washington, DC.
| | | | - Oliver Sartor
- Departments of Urology and Medicine, Tulane University School of Medicine, New Orleans, LA
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9
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Bazargan M, Lucas-Wright A, Jones L, Vargas R, Vadgama JV, Evers-Manly S, Maxwell AE. Understanding Perceived Benefit of Early Cancer Detection: Community-Partnered Research with African American Women in South Los Angeles. J Womens Health (Larchmt) 2015; 24:755-61. [PMID: 26131760 DOI: 10.1089/jwh.2014.5049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND African American women have lower 5-year cancer survival rates than non-Latino White women. Differences in perceived benefits of early cancer detection among racial/ethnic groups may affect cancer-screening behaviors. This study assessed correlates of perceived benefits of early breast, cervical and colorectal cancer detection among 513 African American women. METHODS Using a community-partnered participatory research approach, we conducted a survey on cancer screening, risk behaviors, and related knowledge and attitudes among African American parishioners at 11 churches in South Los Angeles, a neighborhood that experiences one of the highest cancer mortality rates in California. RESULTS African American women who participated in this study were more likely to believe that chances for survival are very good or good after early detection of breast cancer (74%) than after early detection of colorectal (51%) and cervical cancer (52%). Multivariate analyses show that perceived benefit of early cancer detection is associated with higher cancer knowledge and having discussed one's cancer risk with a doctor. CONCLUSIONS Given that 5-year survival rates for early stage breast, cervical, and colorectal cancer range from 84% to 93%, our data suggest that a substantial proportion of African American women in South Los Angeles are not aware of the benefits of early detection, particularly of colorectal and cervical cancers. Programs that increase cancer knowledge and encourage a discussion of individual's cancer risk with a doctor may be able to increase perceived benefit of early detection, a construct that has been shown to be associated with cancer screening in some studies.
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Affiliation(s)
- Mohsen Bazargan
- 1 Charles R. Drew University of Medicine and Science , Los Angeles, California.,3 David Geffen School of Medicine, University of California Los Angeles , Los Angeles, California
| | - Anna Lucas-Wright
- 1 Charles R. Drew University of Medicine and Science , Los Angeles, California.,2 Healthy African American Families , Los Angeles, California
| | - Loretta Jones
- 1 Charles R. Drew University of Medicine and Science , Los Angeles, California.,2 Healthy African American Families , Los Angeles, California
| | - Roberto Vargas
- 3 David Geffen School of Medicine, University of California Los Angeles , Los Angeles, California
| | - Jaydutt V Vadgama
- 1 Charles R. Drew University of Medicine and Science , Los Angeles, California
| | - Shirley Evers-Manly
- 1 Charles R. Drew University of Medicine and Science , Los Angeles, California
| | - Annette E Maxwell
- 4 Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles , Los Angeles, California
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10
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Lucas-Wright A, Bazargan M, Jones L, Vadgama JV, Vargas R, Sarkissyan M, Smith J, Yazdanshenas H, Maxwell AE. Correlates of perceived risk of developing cancer among African-Americans in South Los Angeles. J Community Health 2014; 39:173-80. [PMID: 24026303 DOI: 10.1007/s10900-013-9756-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
There are differences in cancer-risk perception among racial/ethnic groups that may affect health risk behaviors. Using a community partnered-participatory research approach, we conducted a survey on cancer screening, risk behaviors, and related knowledge/attitudes within 11 churches in South Los Angeles with predominantly African-American parishioners. This analysis examines correlates of perceived risk of developing cancer among 755 African American adults. Almost 15 % of participants indicated higher perceived risk for cancer compared to the average man/woman of the same age, 38 % indicated same risk, whereas 48 % perceived lower risk. Sixty-nine individuals (9 %) reported a cancer history and 63 % reported at least one blood relative with cancer. Controlling for demographic characteristics and healthcare access, participants who reported higher risk of cancer had higher level of cancer-related knowledge; were current and ex-smokers; had poorer health status; had a blood relative with cancer; had a cancer history; and had discussed their risk of cancer with their doctor. The bivariate association between high perceived cancer risk and lack of exercise and obesity disappeared after adjusting for demographic characteristics and perceived health status. Our data suggest that a substantial proportion of African Americans in South Los Angeles may underestimate their cancer risk. Additionally, lack of exercise and obesity are not recognized as independent cancer risk factors as much as smoking and personal and family history of cancer. Next steps will be to inform participating churches about our findings and explore their interest in taking steps to reduce health risk behaviors among their parishioners.
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Affiliation(s)
- Anna Lucas-Wright
- Cancer Outreach, Prevention, and Control Program, Center to Eliminate Cancer Health Disparities, Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, CA, 90059, USA
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11
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Hillen MA, de Haes HCJM, Stalpers LJA, Klinkenbijl JHG, Eddes EH, Verdam MGE, Smets EMA. How attachment style and locus of control influence patients' trust in their oncologist. J Psychosom Res 2014; 76:221-6. [PMID: 24529041 DOI: 10.1016/j.jpsychores.2013.11.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 11/23/2013] [Accepted: 11/27/2013] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Cancer patients need to trust their oncologist. How the oncologist communicates probably contributes to patients' trust. Yet, patient characteristics such as their attachment style and health locus of control may influence how such communication is perceived. We examined how these personality characteristics influence trust as well as moderate the relation between oncologist communication and trust. METHODS Eight videotaped scenarios of an oncologic consultation were created. Oncologist communication was systematically varied regarding their expressed competence, honesty and caring. Cancer patients (n = 345) were randomly assigned to view the videos and report their trust in the observed oncologist. Patients' self-reported attachment style, health locus of control and trust in their own oncologist were assessed. RESULTS Patients with a stronger external health locus of control trusted the observed oncologist more (p < .001). Neither attachment avoidance nor attachment anxiety was related to trust in the observed oncologist. However, attachment avoidance moderated the positive effect of the oncologists' communication of caring and honesty on trust: avoidant attachment significantly diminished the effect (p < .011 and p < .044, respectively). High attachment avoidance (p = .003) and attachment anxiety (p < .001) were related to weaker trust in patients' own oncologist. DISCUSSION Patients' attachment avoidance may hamper their trust in their own, but not necessarily in a newly observed, oncologist. As expected, patients' attachment style influences how oncologist communication influences trust, underscoring the importance of oncologists tailoring their communication to individual patients. We confirmed observational findings that patients convinced that others control their health trust their oncologist more than others.
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Affiliation(s)
- Marij A Hillen
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Hanneke C J M de Haes
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Lukas J A Stalpers
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jean H G Klinkenbijl
- Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Eric-Hans Eddes
- Department of Surgery, Deventer Hospital, Deventer, The Netherlands
| | - Mathilde G E Verdam
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ellen M A Smets
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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12
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De Melo-Martín I. The ethics of anonymous gamete donation: is there a right to know one's genetic origins? Hastings Cent Rep 2014; 44:28-35. [PMID: 24532424 DOI: 10.1002/hast.285] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A growing number of jurisdictions hold that gamete donors must be identifiable to the children born with their eggs or sperm, on grounds that being able to know about one's genetic origins is a fundamental moral right. But the argument for that belief has not yet been adequately made.
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13
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Anderson B, Marshall-Lucette S, Webb P. African and Afro-Caribbean men's experiences of prostate cancer. ACTA ACUST UNITED AC 2013; 22:1296-8, 1300-2, 1304-7. [DOI: 10.12968/bjon.2013.22.22.1296] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Patricia Webb
- Social Care and Education, St George's, University of London
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14
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Kirkegaard P, Vedsted P, Edwards A, Fenger-Grøn M, Bro F. A cluster-randomised, parallel group, controlled intervention study of genetic prostate cancer risk assessment and use of PSA tests in general practice--the ProCaRis study: study protocol. BMJ Open 2013; 3:bmjopen-2012-002452. [PMID: 23457331 PMCID: PMC3612777 DOI: 10.1136/bmjopen-2012-002452] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Unsystematic screening for prostate cancer (PCa) is common, causing a high number of false-positive results. Valid instruments for assessment of individual risk of PCa have been called for. A DNA-based genetic test has been tested retrospectively. The clinical use of this test needs further investigation. The primary objective is to evaluate the impact on the use of prostate-specific antigen (PSA) tests of introducing genetic PCa risk assessment in general practice. The secondary objectives are to evaluate PCa-related patient experiences, and to explore sociocultural aspects of genetic risk assessment in patients at high PCa risk. METHODS AND ANALYSIS The study is a cluster-randomised, controlled intervention study with practice as the unit of randomisation. We expect 140 practices to accept participation and include a total of 1244 patients in 4 months. Patients requesting a PSA test in the intervention group practices will be offered a genetic PCa risk assessment. Patients requesting a PSA test in the control group practices will be handled according to current guidelines. Data will be collected from registers, patient questionnaires and interviews. Quantitative data will be analysed according to intention-to-treat principles. Baseline characteristics will be compared between groups. Longitudinal analyses will include time in risk, and multivariable analysis will be conducted to evaluate the influence of general practitioner and patient-specific variables on future PSA testing. Interview data will be transcribed verbatim and analysed from a social-constructivist perspective. ETHICS AND DISSEMINATION Consent will be obtained from patients who can withdraw from the study at any time. The study provides data to the ongoing conceptual and ethical discussions about genetic risk assessment and classification of low-risk and high-risk individuals. The intervention model might be applicable to other screening areas regarding risk of cancer with identified genetic components, for example, colon cancer. The study is registered at the ClinicalTrials.gov (Identifier: NCT01739062).
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Affiliation(s)
- Pia Kirkegaard
- Research Unit for General Practice & Research Centre for Cancer Diagnosis in Primary Care-Aarhus University, Aarhus C, Denmark
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15
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Pedersen VH, Armes J, Ream E. Perceptions of prostate cancer in Black African and Black Caribbean men: a systematic review of the literature. Psychooncology 2011; 21:457-68. [PMID: 21905156 DOI: 10.1002/pon.2043] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 06/10/2011] [Accepted: 07/01/2011] [Indexed: 11/12/2022]
Abstract
BACKGROUND Prostate cancer (PC) is common and affects Black African and Caribbean men disproportionately more than White men. It is known that PC awareness is low in these groups, but knowledge is lacking about other factors that may deter Black men from seeking information about, or getting tested for, PC. The aim of this review was to appraise research on knowledge and perceptions of PC among Black men. METHODS Four medical and social science databases were systematically searched, and reference lists of relevant papers were hand searched. Non-English publications were excluded. Qualitative findings were synthesised using comparative thematic analysis to which quantitative findings were integrated. RESULTS Thirteen qualitative studies and 20 cross-sectional surveys were included. All except two were conducted in the USA. The analysis identified individual, cultural and social factors likely to impact on Black men's awareness of, and willingness to be tested for, PC. Black men's awareness of personal risk of PC varied greatly between studies. Misunderstandings regarding methods of diagnosis and treatment were widespread. PC testing and treatment were perceived as a threat to men's sense of masculinity. Mistrust of the health-care system, limited access to health care and lack of trusting relationships with health professionals were also prominent. CONCLUSION The factors impacting on Black men's awareness of PC may contribute to late PC diagnosis and should be taken into account when communicating with Black men seeking prostate care. Further, the review demonstrated a need for high-quality studies in countries other than the USA to determine the relevance of the review findings for Black men in other nations and continents.
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Affiliation(s)
- Vibe Hjelholt Pedersen
- Supportive Cancer Care Research Team, Florence Nightingale School of Nursing and Midwifery, King's College, London, UK.
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16
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Murthy VS, Garza MA, Almario DA, Vogel KJ, Grubs RE, Gettig EA, Wilson JW, Thomas SB. Using a family history intervention to improve cancer risk perception in a black community. J Genet Couns 2011; 20:639-49. [PMID: 21773879 DOI: 10.1007/s10897-011-9389-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 06/23/2011] [Indexed: 12/12/2022]
Abstract
Few studies examine the use of family history to influence risk perceptions in the African American population. This study examined the influence of a family health history (FHH) intervention on risk perceptions for breast (BRCA), colon (CRC), and prostate cancers (PRCA) among African Americans in Pittsburgh, PA. Participants (n = 665) completed pre- and post-surveys and FHHs. We compared their objective and perceived risks, classified as average, moderate, or high, and examined the accuracy of risk perceptions before and after the FHH intervention. The majority of participants had accurate risk perceptions post-FHH. Of those participants who were inaccurate pre-FHH, 43.3%, 43.8%, and 34.5% for BRCA, CRC, and PRCA, respectively, adopted accurate risk perceptions post-FHH intervention. The intervention was successful in a community setting. It has the potential to lead to healthy behavior modifications because participants adopted accurate risk perceptions. We identified a substantial number of at-risk individuals who could benefit from targeted prevention strategies, thus decreasing racial/ethnic cancer disparities.
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Affiliation(s)
- Vinaya S Murthy
- Department of Clinical Genetics, The Permanente Medical Group, San Jose, CA 95123, USA
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17
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Hillen MA, de Haes HCJM, Smets EMA. Cancer patients' trust in their physician-a review. Psychooncology 2011; 20:227-41. [PMID: 20878840 DOI: 10.1002/pon.1745] [Citation(s) in RCA: 173] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Patient's trust in their physician is crucial for desirable treatment outcomes such as satisfaction and adherence. In oncology, trust is possibly even more essential, due to the life-threatening nature of cancer. A review was undertaken of the current knowledge of the conceptualization, assessment, correlates, and consequences of cancer patients' trust in their physician. METHODS The empirical literature published in peer-reviewed journals between October 1988 and October 2008 was searched, employing all combinations and variations of the following keywords: trust, physician-patient relations, and cancer. RESULTS The search identified 45 relevant papers, only 11 of which drew attention to the conceptualization of trust, and 5 of which focused on trust as the primary subject of interest. Trust in physicians was strong overall. Patients' trust appeared to be enhanced by the physician's perceived technical competence, honesty, and patient-centred behaviour. A trusting relationship between patient and physician resulted in facilitated communication and medical decision making, a decrease of patient fear, and better treatment adherence. CONCLUSIONS A lack of focus on trust and the conceptualization thereof, strong methodological variations between studies and a possible publication bias lead us to conclude that cancer patients' trust in their physician deserves more systematic, theoretically based, research attention. Consequently, studies are needed aimed at gaining a thorough understanding of the nature and impact of cancer patients' trust in their physician, and how the interaction between physician and patient may contribute to such trust.
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Affiliation(s)
- Marij A Hillen
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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Hanson LC. Improving access and quality of care for African Americans with advanced cancer. N C Med J 2009; 70:155-8. [PMID: 19489376 PMCID: PMC4383184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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