Prostate carcinoma knowledge, attitudes, and screening behavior among African-American men in Central Harlem, New York City

BACKGROUND. Although the benefits of prostate carcinoma screening in reduci ng mortality rates have not been proven or shown to be cost-effective, scre ening, particularly using prostate specific antigen (PSA) tests, is widespr ead. A better understanding of screening behavior, knowledge of prostate ca rcinoma risk, and attitudes toward screening among men at high risk, such a s African-American men, would be valuable, METHODS. A prevalence sun ey was conducted using 2 samples of African-Ameri can men, aged 50-74 years: a clinic sample drawn from all clinics in Centra l Harlem (n = 404) and a random-digit dial sample from die same geographic region (n = 319). The prevalence of self-reported PSA screening was estimat ed using a cognitive survey methodology based on the internal consistency o f answers to four different questions. Prevalence estimates were adjusted t o take into account the high proportion of nontelephone residences. RESULTS. The clinic sample, representing a poorer, more ill population las determined by MOS Physical Function Scores, was less likely to report PSA s creening than the community sample (11.1% in clinic sample vs, 25.5% in com munity). The prevalence of PSA testing in Central Harlem overall in this ag e group by using two different techniques was estimated to be 24%. In multi ple logistic models, self-reported PSA screening was associated with age, e ducation, favorable attitudes toward screening, and knowing someone who had prostate carcinoma. However, the association between these factors and the likelihood of self-reported PSA screening differed between clinic and comm unity samples. CONCLUSIONS, The prevalence of self-reported PSA screening in Central Harle m was lower than that reported for other populations. These findings may be useful in the design of health education campaigns and for counseling inne rcity, low-income African-American patients appropriately about the disease . Published 2001 by the American Cancer Society.*