Predictors of participation in prostate cancer screening at worksites

Knowledge, Perceived Risk and Utilization of Prostate Cancer Screening Services among Men in Dar Es Salaam, Tanzania

Background

Late diagnosis of prostate cancer is common in low and middle income countries and contributes to high morbidity and mortality of the disease. Utilization of prostate cancer screening services plays a major role in prevention of adverse outcomes. However, there is limited information on the knowledge about, the perceived risk of, and the utilization of prostate cancer screening in Tanzania.

Objective

To determine knowledge and perceived risk of prostate cancer, and the utilization of prostate cancer screening services, and associated factors, among men in Dar es Salaam, Tanzania.

Design

A population-based cross-sectional study involving men aged 40 years and above living in Dar es Salaam was conducted between May and August, 2018.

Methodology

Participants were recruited through multistage random sampling and took part in structured face-to-face interviews. Categorical variables were summarized using proportions while continuous variables were summarized as medians and inter-quarterly range (IQR). Chi square test was used to compare differences between proportions, and logistic regression modelling was used to determine factors associated with utilization of prostate cancer screening. Both crude and adjusted odds ratios (OR), with corresponding 95% confidence intervals, are reported. All analyses were two-tailed and the significance level set at 5%.

Results

A total of 388 men with a median age of 53 years (IQR 44–55) participated. Half (52.1%) had poor knowledge about prostate cancer and prostate cancer screening. A third (32.3%, n = 125) perceived the risk of prostate cancer to be low. Only 30 respondents (7.7%) had ever been screened for prostate cancer. Utilization of prostate cancer screening services was independently associated with age above 60 years [AOR = 21.46, 95% CI: 6.23, 73.93], monthly income above 305 US Dollars [AOR = 15.68, 95% CI: 4.60, 53.48], the perceived risk of prostate cancer [AOR = 16.34, 95% CI: 7.82, 14.92] and knowledge about prostate cancer [AOR = 67.71, 95% CI: 8.20, 559.57].

Conclusions

Knowledge about prostate cancer and prostate cancer screening services was low among men in Dar es Salaam with a third perceiving themselves to be at no risk for the disease. Utilization of screening services was low and associated with low income, younger age, low perceived risk of prostate cancer and low knowledge about the disease. Intervention measures aiming to increase knowledge about prostate cancer and screening services, and affordable provision of services, are urgently called for.

Organizational-Level Recruitment of Barbershops as Health Promotion Intervention Study Sites: Addressing Health Disparities Among Black Men

This article describes the process and results associated with the organizational-level recruitment of Black barbershops into Fitness in the Shop (FITShop), a 6-month barbershop-based intervention study designed to promote physical activity among Black men. Organizational-level recruitment activities included (1) a telephone call to prospective barbershop owners to assess their interest and eligibility for participation, (2) an organizational eligibility letter sent to all interested and eligible barbershops, (3) a visit to interested and eligible barbershops, where a culturally sensitive informational video was shown to barbershop owners to describe the study activities and share testimonies from trusted community stakeholders, and (4) a signed agreement with barbershop owners and barbers, which formalized the organizational partnership. Structured interviews were conducted with owners of a total of 14 enrolled barbershops, representing 30% of those determined to be eligible and interested. Most enrolled shops were located in urban settings and strip malls. Barbershop owners were motivated to enroll in the study based on commitment to their community, perceived client benefits, personal interest in physical activity, and a perception that the study had potential to make a positive impact on the barbershop and on reducing health disparities. Results offer important insights about recruiting barbershops into intervention trials.

Information gathering and technology use among low-income minority men at risk for prostate cancer

Health communication researchers, public health workers, and health professionals must learn more about the health information-gathering behavior of low-income minority men at risk for prostate cancer in order to share information effectively with the population. In collaboration with the Milwaukee Health Department Men's Health Referral Network, a total of 90 low-income adult men were recruited to complete a survey gauging information sources, seeking behavior, use of technology, as well as prostate cancer awareness and screening behavior. Results indicated participants primarily relied on health professionals, family, and friends for information about general issues of health as well as prostate cancer. The Internet was the least relied on source of information. A hierarchical regression indicated interpersonal information sources such as family or friends to be the only significant predictor enhancing prostate cancer awareness, controlling for other sources of information. Prostate screening behaviors were predicted by reliance on not only medical professionals but also the Internet. Practical implications of the study are discussed.

Social epidemiology: a tool for examining prostate cancer early-detection decision making among older African American men

The article explores the disparate burden of prostate cancer among older African American men, and this population's minimal use of cancer early-detection strategies. Social epidemiology is introduced as an emerging field that studies the social context of disease with an emphasis on how macrostructural forces and human interactions affect population health. A conceptual model is presented as a social epidemiological tool for investigating complex health and social issues and developing culturally relevant programs and interventions based on empirical findings. The model is then applied to the problem of prostate cancer early-detection decision making among older African American men.

Use of the prostate-specific antigen test among U.S. men: findings from the 2005 National Health Interview Survey

BACKGROUND

Although evidence that prostate cancer deaths are reduced by screening for elevated prostate-specific antigen (PSA) concentration coupled with early diagnosis and treatment is insufficient to advocate routine screening for prostate cancer, PSA testing has become more common in the past decade. We examined characteristics that might influence testing and compared test use between men ages 40 to 49 and 50 to 79 years.

METHODS

We used data from 7,669 participants with no history of prostate cancer in the 2005 National Health Interview Survey.

RESULTS

Among men reporting about PSA testing, an estimated 16% of 40- to 49-year-old men and 49% of 50- to 79-year-old men had a PSA test in the past 2 years. In multivariate analyses, among men ages 40 to 49 years, non-Hispanic Black men were more likely (P < 0.05) to have had a PSA test than non-Hispanic White men. We found no significant difference by race/ethnicity in men ages 50 to 79 years. Higher education, higher poverty threshold, usual source of medical care, family history of prostate cancer, and comorbid conditions were associated with increased PSA test use in both age groups. Additionally, men ages 50 to 79 years born in the United States, who were married, had private or military health insurance, and had been diagnosed with another cancer type were more likely to be tested.

CONCLUSIONS

Findings from the multivariate analyses indicated significantly higher PSA test use among younger non-Hispanic Black men than among non-Hispanic White men. These findings may indicate that healthcare providers are getting and conveying the message of increased risk of prostate cancer among African American men.

Increased cancer risk for individuals with a family history of prostate cancer, colorectal cancer, and melanoma and their associated screening recommendations and practices

Prostate cancer, colorectal cancer, and melanoma are three malignancies that appear to have strong genetic components that can confer additional risk to family members. Screening tools, albeit controversial, are widely available to potentially aide in early diagnosis. Family members are now more attuned to the risks and benefits of cancer screening, thus, it is imperative that physicians understand the screening tools and how to interpret the information they provide. We reviewed the current literature regarding the cancer risks for individuals with a family history of prostate cancer, colon cancer, and melanoma, the current screening recommendations for family members, and actual screening practices of individuals with a family history of these malignancies. This review should serve as a guide for physicians and cancer control planners when advising their patients and the public regarding screening decisions.

Body mass index and intake of selected foods in African American men

BACKGROUND

There are minimal data on the relationship between dietary consumption of fats, vegetables, and fruits and body mass index (BMI) in African American men.

OBJECTIVE

This study tested the relationships between selected dietary consumption and BMI.

DESIGN

The sample was a community-based cohort of 204 African American Southern men who attended a free prostate cancer educational and screening program. The screening was part of an all-day African American celebration that included a health fair. Diet was assessed with a Brief Dietary Scale for Selected Food Intake and Preparation.

RESULTS

Most of the men were overweight (34%) or obese (47%). The majority of men ate their chicken (90%) and fish (96%) fried. Few men ate vegetables at supper (29.4%) or lunch (15.8%). Three fatty food items were significantly associated with BMI: leaving the chicken skin on chicken (p=.03); intake of low-fat or skim milk (p=.02); and cooking vegetables with butter (p=.03).

CONCLUSION

African American men need culturally appropriate dietary interventions to reduce obesity.

Prostate cancer screening decision making under controversy: implications for health promotion practice

Prostate cancer is a major health problem for U.S. men and is characterized by paradoxes and controversies. Despite the wide availability of the prostate-specific antigen (PSA) test, prostate cancer screening remains a controversial practice mainly because the direct impact of screening on mortality is not yet proven. As the relative value of screening, early detection, and treatment strategies continue to be debated, glaring racial-ethnic disparities persist with African American men experiencing excess morbidity and mortality and demonstrating the lowest screening rates among racial-ethnic groups. Given the prevailing controversy, uncertainty, and known disparities, how can health education messages be framed to assist men and their family members? This article highlights the ethnic disparities, paradoxes, and controversies of prostate cancer and identifies critical challenges and opportunities for health educators and clinical practitioners. Implications for health promotion communications and informed decision making in this era of uncertainty are discussed.

Predictors of prostate cancer screening among health fair participants

OBJECTIVES

Most previous studies of predictors for participation in prostate-specific antigen (PSA) screening for prostate cancer have been conducted in purposive samples or clinical settings. This population-based study identified factors associated with documented PSA screening among health fair participants.

STUDY DESIGN

Cross-sectional survey of 2098 Nebraskan men aged 35 years and older who participated in a health fair in central and eastern Nebraska in 1993.

METHODS

All participants were offered a PSA screening and a questionnaire to collect information on demographics, family medical history, lifestyle factors and self-perceived health status. Predictors of PSA screening were estimated by odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Men were more likely to accept the PSA screening if they were older than 50 years of age (OR=3.1; 2.4-3.9), had a higher income (OR=1.5; 1.1-2.1), were currently employed (OR=1.4; 1.0-2.5), perceived their health status as good (OR=1.1; 0.8-1.5) or excellent (OR=1.4; 1.0-2.1), and believed that they themselves, rather than physicians, should be responsible for their health (OR=1.3; 1.0-1.7). Compared with men aged 50-59 years, the ORs of participation were 0.8 (0.6-1.1) for age 60-69 years and 0.7 (0.5-1.1) for age 70+ years. Decision making was not related to education, marital status or body mass index. Predictors of screening remained unchanged when analysis was limited to men aged 50 years and over, whereas only high income and non-smoking status predicted participation among men younger than 50 years of age.

CONCLUSIONS

Age, income, employment status, perceived control of health and perceived heath status were related to participation in PSA screening for prostate cancer, particularly in men older than 50 years of age. Willingness to receive a PSA screening among men aged 50 years and over decreased with increasing age.

Needs analysis of a cancer education program in south western Sydney

Before establishing a cancer education program in South Western Sydney (SWS), a study was conducted to investigate the level of interest and presentation format preferred by patients with cancer and their relatives/friends regarding five types of cancer-related information: medical, psychological, and physical care issues as well as support services and available resources. A questionnaire using a Likert scale and open- and close-ended questions was distributed to the local cancer population and their families comprising a total sample size of 141. The results showed a uniformly high level of interest in learning about all five cancer-related topics with a preferred program format that consisted of a mixed media presentation of 1 to 6 weeks duration, consisting of 1- to 2-hour weekly sessions. A cancer education program based on the needs assessment findings was developed and implemented at Liverpool Hospital, which was positively evaluated by participants.