Race, Decisional Regret and Prostate Cancer Beliefs: Identifying Targets to Reduce Racial Disparities in Prostate Cancer.

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  • Additional Information
    • Source:
      Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 0376374 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-3792 (Electronic) Linking ISSN: 00225347 NLM ISO Abbreviation: J Urol Subsets: MEDLINE
    • Publication Information:
      Publication: 2019- : [Philadelphia, PA] : Wolters Kluwer
      Original Publication: Baltimore : Lippincott Williams & Wilkins
    • Subject Terms:
      Culture* ; Decision Making* ; Emotions*; Black or African American/*statistics & numerical data ; Prostatic Neoplasms/*psychology ; Prostatic Neoplasms/*therapy; Cohort Studies ; Healthcare Disparities ; Humans ; Male ; Middle Aged ; Racial Groups/statistics & numerical data
    • Abstract:
      Purpose: African American men are more likely to be diagnosed with, die of and experience decisional regret about their prostate cancer than nonAfrican American men. Although some clinical discrepancies may be attributed to genetic risk and/or access to care, explanations for racial discrepancies in decisional regret remain largely speculative. We aim to identify sources of prostate cancer decisional regret with a focus on racial disparities.
      Materials and Methods: A cohort of 1,112 patients with localized prostate cancer treated at the Cleveland Clinic between 2010 and 2016 were matched by race, Gleason score, treatment (external beam radiation, brachytherapy, prostatectomy, active surveillance), prostate specific antigen at diagnosis, age at treatment and time since treatment. All patients received 4 surveys, including the Expanded Prostate Cancer Index Composite (EPIC) 26, the Decisional Regret Scale, our novel Prostate Cancer Beliefs Questionnaire and a modified EPIC demographics form. Descriptive and comparative statistics and multivariable logistic regression were used to compare survey outcomes by race and treatment method.
      Results: Of 1,048 deliverable surveys 378 (36.07%) were returned. African American men had worse decisional regret than nonAfrican American men even after adjusting for relevant covariates (OR 2.46, p <0.0001). African American men also had higher Prostate Cancer Beliefs Questionnaire medical mistrust and masculinity scores, both of which predicted worse decisional regret independent of race (1.415 and 1.350, p=0.0001, respectively).
      Conclusions: African American men suffer worse decisional regret than nonAfrican American men, which may be partially explained by higher medical mistrust and concerns about masculinity as captured by the Prostate Cancer Beliefs Questionnaire. This novel survey may facilitate identifying targets to reduce racial disparities in prostate cancer.
    • Comments:
      Comment in: J Urol. 2021 Feb;205(2):432-433. (PMID: 33226308)
    • Contributed Indexing:
      Keywords: decision making; healthcare disparities; prostatic neoplasms
    • Publication Date:
      Date Created: 20201123 Date Completed: 20210225 Latest Revision: 20221207
    • Publication Date:
      20221213
    • Accession Number:
      10.1097/JU.0000000000001385
    • Accession Number:
      33226309