Personal Factors Affecting African-American Men’s Prostate Cancer Screening Behavior

Folakemi T. Odedina, PhD; Ellen S. Campbell, PhD; Margareth LaRose-Pierre, PharmD; John Scrivens, PhD; and Angela Hill, PharmD JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION VOL. 100, NO. 6, JUNE 2008 Prostate cancer continues to be a health crisis among African-American men due to the disproportionate morbidity and mortality burden experienced by this population. Within the United States, African-American men have the highest prostate cancer incidence rate compared to other ethnic/racial groups. During 2000–2003, prostate cancer mortality rate among African-American men was 2.4 times higher than that of white men. Although there is an overall decline in prostate cancer morbidity, the decline seen in African-American men is negligible compared to white men. The potential sources of this prostate cancer health disparity include individual (personal or provider), institutional and health systems factors. The personal level as a source of prostate cancer health disparity cannot be ignored given that behavioral choice is debatably the most influential determinant of population health. In general, physicians usually provide the cues for prostate cancer screening tests. However, once screening recommendations are provided by physicians, the ultimate decision to screen or not to screen typically rests on each individual. Thus, individual behaviors remain a key weapon to eliminate prostate cancer health disparity.