title: Culture, black men, and prostate cancer: what is reality?
abstract: BACKGROUND
  The worldwide incidence of prostate cancer is higher among American black men than any other male group. In the United States, lack of participation in screening for prostate cancer by black men is influenced by several cultural factors, including knowledge, health beliefs, barriers, and relationships with primary healthcare providers.
  
  
  METHODS
  We used the qualitative and paralleling descriptive quantitative findings of a mixed-method longitudinal study exploring prostate cancer screening behaviors among 277 black men.
  
  
  RESULTS
  Five themes were identified as critical elements affecting men's screening for prostate cancer: lack of knowledge, communication, social support, quality of care, and sexuality. These themes were associated with a sense of disconnectedness by black men from the healthcare system and contributed to nonparticipation in prostate cancer early detection activities.
  
  
  CONCLUSIONS
  Lack of discussion about the decision to screen for prostate cancer and general lack of culturally appropriate communication with healthcare providers has engendered distrust, created fear, fostered disconnect, and increased the likelihood of nonparticipation in prostate cancer screening among black men.
authors.affiliation: School of Public Health, Loma Linda University, CA 92350, USA. vwoods@sph.llu.edu
authors.forename: V Diane
authors.initials: VD
authors.lastname: Woods
authors.forename: Susanne B
authors.initials: SB
authors.lastname: Montgomery
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Belliard
authors.forename: Johnny
authors.initials: J
authors.lastname: Ramirez-Johnson
authors.forename: Colwick M
authors.initials: CM
authors.lastname: Wilson
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D002140:California; D015331:Cohort Studies; D003469:Culture; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011369:Professional-Patient Relations; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D036301:Qualitative Research; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012944:Social Support; D012959:Socioeconomic Factors