HEALTH DISPARITY

Vulnerable Population/ Health Disparity: African American Men and Prostate Screening

Vulnerable Population/ Health Disparity: African American Men and Prostate Screening

Introduction

Prostate cancer is the most commonly diagnosed cancer in men and the second leading cause of cancer deaths among men in the United States, after lung cancer. The American Cancer Society has estimated that 186,320 men in the United States will be newly diagnosed with prostate cancer in the United States during 2008, and the cancer will kill 28,660 men. Prostate cancer affects African American men disproportionately; they have the highest incidence of prostate cancer at 248.5 cases per 100,000 compared to 156.7 cases per 100,000 white men and 138.0 cases per 100,000 Hispanic men. African Americans are also more likely to be diagnosed with a neoplasm that has spread beyond the immediate adjacent organs or tissues and have tumors metastasized to distant lymph nodes. (Wolff et.al 2003) The US Preventive Services Task Force has concluded that the evidence is insufficient to recommend for or against routine screening for prostate cancer. Although screening has not been shown to directly decrease mortality, it offers the only possibility for early detection of prostate cancer. Early detection is particularly important for high-risk individuals such as African Americans and individuals with a first-degree relative (ie, father, brother) who have had prostate cancer.

Vulnerable Population

A qualitative research design was used to explore rural African American men's experiences in decision making regarding prostate cancer screening. A hermeneutic phenomenological approach was used to analyze the data. This method incorporates interpreting text in context to explore, interpret, and describe areas of experience that are complex and not fully understood. Specifically, the participants are encouraged to communicate their experiences in narrative form and explain the situations in which events happened as well as the meanings that the participants found in their experiences. Participants were asked to talk about how they decided whether or not to be screened for prostate cancer. (Williams's et.al 2006)The data from individual narratives about deciding to have or not to have prostate cancer screening were first analyzed to understand the individual meanings ascribed by the participants. Subsequently, the data from all the narratives together were examined, grouped, and categorized based on common relationships, ideas, beliefs, and options. Finally, the data analysis was an explanation and depiction of their decisions about prostate cancer screening.

A total of 17 men were interviewed. The men were informed that they would receive $30 for participating in the interviews. A consent form was completed by the participants before the interview began. Individuals generally feel more comfortable talking about their health beliefs, attitudes, and practices when they are in a setting in which they do not feel threatened. (Richardson et.al 2004) Therefore, one-on-one interviews were conducted in private rooms of public libraries, in participants' homes, or in other nonintimidating settings that were convenient to the participants.

Rationale

A semistructured interview guide that included both closed and open-ended questions were used with each participant. The interview guide was initially created by one of the authors ...