Financial and health disparities among AA and CA men
As indicated above, there were three parts of the questionnaire: the demographics, the knowledge on prostate cancer, and the psychological impact of being diagnosed with the disease. The pertinent demographic comparison is depicted in Figure 1. There was a significant difference in the martial status (p<.001) as demonstrated in fig 1, 26.9% of AA were surveyed are single and did not have the support that CA men had upon entering the clinic. This suggested that their decision making concerning their disease would be upon their shoulder without the input of significant others. AA men had lower income overall while more CA men had over $70,000 annual income (p<.004). With regards to current health status and how often they visit a primary health physician, we found that CA men visited a health care provider more than AA men. In addition, CA men had a better health status than AA men (p<.001). Figure 1 shows a fair health status of 18.4% for CA and 33.3% for AA men. While only 4.4% of AA men showed excellent health, status compared to 19.7% CA men. The insinuation here is that the men surveyed were not in good health when coming to the clinic, and that AA men exhibited adverse contributing health factors when it came time for their diagnosis. There were a limited number of individuals who declined to be surveyed for no reason other than they felt it was not connected to their diagnosis.
Differences of prostate cancer knowledge in AA men and CA men:
Based on the data obtained from the questionnaire, the knowledge of prostate cancer varied widely between AA men and CA men. The results are summarized in Table 1 demonstrates that AA men have significantly less knowledge compared to CA men as evident in answering questions related to being diagnosed with prostate cancer and questions related to PSA, biopsy, and Gleason score. When answering the question “men diagnosed with prostate cancer should be treated immediately”, there was a significant difference (p<.001) in the answers given between AA and CA men. We also asked if “all men should be tested for Prostate cancer” 1% of men said “True”. Conversely, 9% men said “False”, not all men should be tested. When asked “men of all ages can be diagnosed with PCa” 13.3% of AA men answered “False” compared to 3.8% of CA men that shows AA men have significantly (p<.001) less knowledge of PCa compared to CA men.
Answers to the questions related to the understanding of prostate cancer diagnosis, general knowledge, biopsy, and Gleason score indicates that AA men have less knowledge as compared to CA men. Notably, 18.5% of AA men compared to 46.5 % of CA men said that the Gleason score was explained to them, and 15.6% of AA men and 40.9% of CA men understood what a Gleason score indicates. Patient’s Primary Care physician or Urologist would have been the one to explain what a Gleason score consist of. This question also leads to a finding of the knowledge of prostate biopsy. CA men at 42.8% compared to AA men at 20.1% stated that they knew a lot about what a prostate biopsy consists of. This provides further evidence of lack of prostate cancer knowledge. Additionally, based on the demographic data retrieved from this study AA men have less education and are more economically challenged then the CA men.
The second part of the questionnaire focused on the psychological effects of being diagnosed with prostate cancer. As shown in Table 2, anxiety in AA men was significantly greater than in CA men once they were diagnosed with prostate cancer. It is possible that increased anxiety may have an impact on how an individual understands the disease. AA men with PCa compared to CA men were more restless and anxious when told of diagnoses, along with having a routine lifestyle change due to the stress of being diagnosed. In this study there is a disparity between the number of CA and AA men that participated, primarily because most of them came from our Urology clinic at Roswell Park Comprehensive Cancer Center (RPCCC) or a related community event held on site. We hypothesize that this disparity exists from medical mistrust and not having a complete knowledge and understanding of what this may provide in your decision making in the future. With this we decided to investigate and incorporate other institutions for future studies.