Prostate Cancer Screening in African-American Men: The Impact of Worry and Demographic Factors

Lehto, Rebecca H.

Wednesday, July 13, 2011: 2:05 PM

Rebecca H. Lehto, PhD, RN
College of Nursing, Michigan State University, East Lansing, MI
Karen Farchaus Stein, PhD, RN, FAAN
School of Nursing, University of Michigan, Ann Arbor, MI

Learning Objective 1: The learner will be able to distinguish general and specific worry and the significance of worry to behavioral health outcomes.

Learning Objective 2: The learner will be able to identify the role of worry and demographic factors on prostate cancer screening behavior in African American men.

Purpose: Despite the highest prostate cancer incidence and mortality worldwide, African-American(AA) men fall behind in prostate cancer screening(PCS) rates compared to other ethnic groups. PCS results in earlier detection and thus higher prospects for cure in AA men. Worry, aversive repetitive cognitions about perceived concerns, is recognized as an important factor influencing screening and preventive health behaviors in the general population. Scant research has examined if worry is associated with PCS in AA men. The purpose of the study were to examine relationships of worry and demographic factors (age, health insurance, education, marital status) to PCS behaviors in AA men.

Methods: The descriptive cross-sectional study was guided by the Socio-ecologic theory. The sample were 60 AA men(mean age 54.8+10.13) recruited from an urban Midwest area. Surveys included general Penn State Worry Questionnaire; PCS and Health Behaviors Questionnaire; and Cancer-related questionnaire (specific to prostate cancer worry). Descriptive, t-test, and correlations statistics were used.

Results: Age (r = .50,p<.005) and health insurance (r=.31,p<.05) were factors related to PCS. Men >50years were more likely to be screened (t=-5.7,df=59,p<.001) and have higher prostate cancer worry(t=-2.3,df=59,p<.05). General worry was not related to PCS, but was inversely related to other health-promoting behaviors(r=-.30,p<.05).

Conclusion: Worry specific to prostate cancer is higher in older AA men who also are more likely to have been screened. While higher general worry may reduce participation in positive health behaviors, higher specific worry related to prostate cancer risk may promote PCS. The findings can be used to assist the development of screening and preventive health programs, particularly for younger AA men. Research that examines worry and socio-ecologic factors that promote PCS in diverse samples of black men globally is needed to reduce the impact of this deadly disease on this underserved population.

Support: T32 NR0704; MESA Center for Health Care Disparities, NINR.

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