KNOWLEDGE, BELIEFS, AND PRIOR SCREENING BEHAVIOR AMONG BLACKS AND WHITES REPORTING FOR PROSTATE-CANCER SCREENING

Objectives. A survey to determine prostate cancer-related knowledge, b eliefs, acid prior screening behavior was administered to men particip ating in prostate cancer screening events at nine major sites in the s outheast. Since prostate cancer disproportionately affects blacks, a p rimary focus of the analysis was to determine if differences in respon ses exist between racial groups. Methods. A 20-question, multiple-choi ce survey to ascertain prostate cancer knowledge and beliefs, demograp hics, and health care access information was administered at nine majo r southeastern sites participating in Prostate Cancer Awareness screen ing events. Potential differences between the responses of blacks and whites were tested using the Cochran-Mantel-Haenszel test (P < 0.05), adjusting for differences among sites. Results. Major findings of this study on 286 black and 1218 white men are as follows: (1) only 28% of black or white men report that their doctor ever discussed a test for prostate cancer with them; (2) blacks were less likely to have a regu lar doctor (P = 0.03) or ever to have had a digital rectal examination (P < 0.001) or prostate-specific antigen testing (P = 0.005); (3) bla cks were less likely to report knowing someone with prostate cancer (P < 0.001) and were more ape to report their acquaintances experiencing post-treatment impotence than whites (P = 0.03); they were less likel y to report that ''a man with prostate cancer can lead a normal life'' (P < 0.001) or that ''men can have prostate cancer without symptoms'' (P < 0.001); (4) a substantial number of all men did not know that ra ce and/or heredity are risk factors; and (5) ''peace of mind'' was the leading reason why men (65% of whites and 50% of blacks) attended pro state cancer screening events. Conclusions. There are a number of simi larities among black and white men regarding knowledge and beliefs rel ated to prostate cancer. Important differences, however, in access to screening, perception of the disease and its treatment, and knowledge of risk factors exist between racial groups and represent significant barriers to early detection among African Americans,