title: Patient and Physician Factors Associated with Undisclosed Prostate Cancer Screening in a Sample of Predominantly Immigrant Black Men.
abstract: Medical guidelines do not recommend prostate cancer screening, particularly without informed and shared decision making. This study investigates undisclosed opportunistic screening using prostate specific antigen (PSA) testing in black immigrant and African American men. Participants (N = 142) were insured urban men, 45- to 70-years old. Patients' reports of testing were compared with medical claims to assess undisclosed PSA testing. Most (94.4 %) men preferred to share in screening decisions, but few (46.5 %) were aware PSA testing was performed. Four factors predicted being unaware of testing: low formal education, low knowledge about prostate cancer, no intention to screen, and no physician recommendation (all p's < .05). Undisclosed PSA testing was common. Both patient and provider factors increased risk of being uninformed about prostate cancer screening. Interventions combining patient education and physician engagement in shared decision making may better align practice with current prostate cancer screening guidelines.
authors.affiliation: Department of Social and Behavioral Sciences, College of Public Health, Temple University, 957 Ritter Annex, 1301 Cecil B. Moore Ave, Philadelphia, PA, 19122, USA. slepore@temple.edu.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Lepore
authors.affiliation: Department of Biostatistics and Epidemiology, College of Public Health, Temple University, 1301 Cecil B. Moore Ave, Philadelphia, PA, 19122, USA.
authors.forename: Rasmi G
authors.initials: RG
authors.lastname: Nair
authors.affiliation: Department of Health Outcomes and Behaviors, Moffitt Cancer Center, Tampa, FL, 33612, USA.
authors.forename: Stacy N
authors.initials: SN
authors.lastname: Davis
authors.affiliation: Department of Health and Behavioral Studies, Teachers College, Columbia University, 525 West 120th Street, New York, NY, 10027, USA.
authors.forename: Randi L
authors.initials: RL
authors.lastname: Wolf
authors.affiliation: Department of Health and Behavioral Studies, Teachers College, Columbia University, 525 West 120th Street, New York, NY, 10027, USA.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Basch
authors.affiliation: 1199SEIU Benefit and Pension Funds, 330 W. 42nd Street, New York, NY, 10036, USA.
authors.forename: Nigel
authors.initials: N
authors.lastname: Thomas
authors.affiliation: 1199SEIU Benefit and Pension Funds, 330 W. 42nd Street, New York, NY, 10036, USA.
authors.forename: Celia
authors.initials: C
authors.lastname: Shmukler
authors.affiliation: 1199SEIU Benefit and Pension Funds, 330 W. 42nd Street, New York, NY, 10036, USA.
authors.forename: Ralph
authors.initials: R
authors.lastname: Ullman
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D003657:Decision Making; D055088:Early Detection of Cancer / Q000379:methods*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D017430:Prostate-Specific Antigen / Q000032:analysis*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D012959:Socioeconomic Factors
chemical_list: D017430:Prostate-Specific Antigen
keywords: Informed decision making; Minority health; Patient preferences; Prostate cancer screening; Shared decision making