title: Perceived barriers to prostate cancer screenings among middle-aged men in north-eastern Germany.
abstract: OBJECTIVE
  Prostate cancer ranks high in mortality. Only 18% of men entitled for screenings take advantage of this. Social-cognitive models of health psychology describe and predict health behavior. This study investigates what barriers men perceive that impede the utilization of cancer screenings.
  
  
  METHODS
  Semistructured interviews were conducted in 2 general practices and 3 hospital wards. One hundred and seventy-eight men over 45 years were addressed; 64 utilized cancer screenings regularly, 3 had a diagnosis of prostate cancer, and 18 declined participation.
  
  
  METHODS
  Content analyses were conducted with 83 interviews. The interview tapped into the following domains: barriers, risk perception, outcome expectancies, self-efficacy, and intentions.
  
  
  RESULTS
  57 men regarded their health as very important, while 47 had never utilized cancer screenings. Barriers were divided into emotional/cognitive versus organizational/structural. Sixty-four men did not utilize cancer screenings because of lack of symptoms, 22 feared a positive result, 20 had more pertinent health issues, and 18 assumed that their physicians would screen for cancer "automatically."
  
  
  CONCLUSIONS
  Mainly emotional/cognitive barriers were seen as important for nonutilization, especially the absence of symptoms. Following the reasoning of social-cognitive models, a first step to enhance utilization rates would be to enhance risk perception.
authors.affiliation: Institute for Medical Psychology, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany. hannoeve@uni-greifswald.de
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hannöver
authors.forename: David
authors.initials: D
authors.lastname: Köpke
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Hannich
mesh_terms: D000367:Age Factors; D003071:Cognition; D055088:Early Detection of Cancer / Q000523:psychology*; D004644:Emotions; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D017060:Patient Satisfaction; D010465:Perception; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000523:psychology; D011594:Psychometrics; D012306:Risk; D020377:Self Efficacy