African American men; Avoidance; Cure; Diagnosis; Discrimination in medical care; Fatalism; Fate and fatalism; Impotence; Incontinence; Morbidity; Pain; Prostate – Cancer; Prostate – Cancer – Diagnosis; Prostate – Cancer – Treatment; South Carolina; Tumors – Classification; Tumor grade; Tumor stage; Urinary incontinence


Clinical Epidemiology | Oncology | Public Health | Race and Ethnicity


BACKGROUND: The death rate for prostate cancer (PrCA), the most commonly diagnosed cancer in African-American (AA) men, is twice the rate of European-American (EA) men. AA men in South Carolina have the highest age-adjusted death rate in the nation. Studies have shown that treatment offered to AA men with PrCA is systematically different from that offered to EA men. METHODS: Surveys were mailed to 1,866 men in South Carolina with a diagnosis of PrCA. South Carolina men diagnosed with PrCA between 1996 and 2002 were eligible to participate. We performed a descriptive assessment of the factors that influenced PrCA treatment decisions. RESULTS: The treatment choices of AA men were significantly more likely to be influenced by pain and significantly less likely to be influenced by potential for cure compared to EA men. CONCLUSIONS: Providers must be cognizant of the factors that influence treatment, particularly in AA men. Despite the national undertaking to eliminate health disparities, the United States is far from implementing a comprehensive focus on the health of AA men, despite their elevated PrCA morbidity and mortality rates.