EARLY CANCER DETECTION BEHAVIOURS AMONG BLACK MALES

Background and Objective

It is believed that the differentials in the chances of surviving cancer diagnoses may be due to barriers that limit access to timely, appropriate, and high-quality medical care. Understanding the motivation for early cancer detection behaviour among Black males may begin to diminish the prevalence of having an imminent and aggressive cancer diagnosis among this gendered population. To add to this understanding, this study examined perceptions, beliefs, and engagement in early detection cancer behaviour in a sample of Black males 23–63 years of age.

Materials and Methods

Participants (N=312) responded to survey items assessing knowledge, beliefs, and perceptions of cancer, early cancer detection behaviour, illness attitude, masculinity, attachment style, and demographic character-istics via a Qualtrics link published on Amazon MTurk. Using hierarchical regression models, associations were estimated between demographic variables, social (illness attitude, identity), behavioural (masculinity, attachment) variables, and early cancer detection behaviour.

Results

Data showed age (β = -.28, p<.01), education (β = -.180, p<.01), illness attitude (β = .24, p<.01), masculinity (β = -.22, p<.01), and avoidant (β = .31, p<.01) and anxious (β = -.14, p<.01) attachment being associated with early cancer detection behaviour among Black males.

Conclusion

Understanding the motivation for early cancer detection behaviours may begin to address the use of mechanisms, by which to ensure a timely diagnosis, of preventable cancers, among this adult population. Our findings should be useful for researchers seeking to understand why people resist beneficial health information, and for practitioners who aim to create interventions that may reduce such resistance.

1. American Cancer Society. Cancer Facts & Figures 2016. 2017. Available at: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2016.html.

2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA: a cancer journal for clinicians 2016;66(1):7–30.

3. National Cancer Institute. Surveillance, Epidemiology, and End Results Program. Fast Facts. Age-Adjusted SEER Incidence Rates by Sex All Sites All Ages. 2016. Avail-able at: http://seer.cancer.gov/statfacts/html/prost.html. 

4. DeSantis CE, Siegel RL, Sauer AG, et al. Cancer statistics for African Americans, 2016: progress and opportunities in reducing racial disparities. CA: a cancer journal for clinicians 2016;66(4):290–308.

5. Dobbs RW, Greenwald DT, Wadhwa H, et al. Is prostate cancer stage migration continuing for Black men in the PSA era? Prost Cancer Prostat Dis 2017.

6. Valeri L, Chen JT, Garcia-Albeniz X, Krieger N, et al. The role of stage at diagnosis in colorectal cancer black–white survival disparities: a counterfactual causal inference approach. Cancer Epidemiol Prevent Biomark 2016;25(1):83–89.

7. Gilbert KL, Ray R, Siddiqi A, Shetty S, et al. Visible and invisible trends in black men’s health: pitfalls and promises for addressing racial, ethnic, and gender ineq-uities in health. Ann Rev Pub Health 2016;37:295–311. 

8. Atakere DK, Baker TA. Immuned by race: Ethnic identity, masculinity, and attachment as predictors of cancer screening among Black men. Psychology 2016;7(07):1023.

9. Atakere DK, Baker TA. Predictors of perceived vulner-ability to cancer diagnoses among adult Black males. J Health Psychol 2017;DOI: 10.1177/1359105317695426

10. Calvert WJ, Isaac-Savage EP. Motivators and barriers to participating in health promotions behaviors in black men. West J Nurs Res 2013;35:829–48.

11. Jackson CL, Hu FB, Kawachi I, Williams DR, et al. Black–White differences in the relationship between alcohol drinking patterns and mortality among US men and women. Am J Pub Health 2015;105(S3):S534–S543. 

12. Gordon DM, Hawes SW, Reid AE, et al. The many faces of manhood: Examining masculine norms and health behaviors of young fathers across race. Am J Pub Health 2013;7(5):394–401

13. Vogel, DL, Wester SR, Hammer JH, et al. Referring men to seek help: The influence of gender role conflict and stigma. Psychol Men Masculin 2014;15(1):60.

14. Griffith DM. “I AM a man”: manhood, minority men’s health and health equity. Ethnicity Dis 2015;25(3):287–93.

15. Power E, Van Jaarsveld CH, McCaffery K, et al. Un-derstanding intentions and action in colorectal cancer screening. Ann Behav Med 2008;35:285–94. doi: 10.1007/s12160–008-9034-y

16. Allen JD, Kennedy M, Wilson-Glover A, et al. African-American men’s perceptions about prostate cancer: implications for designing educational interventions. Soc Sci Med 2007;64(11):2189–200.

17. Ciechanowski PS, Walker EA, Katon WJ, et al. Attach-ment theory: a model for health care utilization and somatization. Psychosomat Med 2002;64(4):660–67.

18. Cook SH, Watkins DC, Calebs BJ, et al. Attachment orientation and sexual risk behaviour among young Black gay and bisexual men. Psycholog Sexual 2016;7(3):177–96.

19. Brenner H, Stock C, Hoffmeister M. Effect of screening sigmoidoscopy and screening colonoscopy on colorec-tal cancer incidence and mortality: systematic review and meta-analysis of randomised controlled trials and observational studies. BMJ 2014;348:g2467.

20. Phinney JS, Ong AD. Conceptualization and measurement of ethnic identity: Current status and future directions. J Counsel Psychol 2007;54(3):271.

21. Kellner R, Abbott P, Winslow WW, et al. Fears, beliefs, and attitudes in DSM-III hypochondriasis. J nerv Mental Dis 1987;175(1):20–25.

22. Levant RF, Hall RJ, Rankin TJ. Male Role Norms Inventory–Short Form (MRNI-SF): Development, confirmatory factor analytic investigation of structure, and measurement invariance across gender. J Counsel Psychol 2013;60(2):228.

23. Lo C, Walsh A, Mikulincer M, Gagliese L, et al. Meas-uring attachment security in patients with advanced cancer: psychometric properties of a modified and brief Experiences in Close Relationships scale. Psycho- Oncol 2009;18(5):490–99.

24. Dean LT, Subramanian SV, Williams DR, et al. Getting black men to undergo prostate cancer screening: the role of social capital. Am J Men’s Health 2015;9(5):385–96. 

25. Baker TA, Roker R, Collins HR, et al. Beyond race and gender: Measuring behavioral and social indicators of pain treatment satisfaction in older Black and White cancer patients. Gerontol Geriatr Med 2016;1–8.

26. Baker TA, Whitfield KE. Physical functioning in older blacks: an exploratory study identifying psychosocial and clinical predictors. J Nat Med Assoc 2006;98(7):1114.

27. Cobran EK, Wutoh AK, Lee E, et al. Perceptions of prostate cancer fatalism and screening behavior between United States-born and Caribbean-born Black Males. J Immigrant Minor Health 2014;16(3):394–400.

28. Williams PB, Sallar AM. Retraction Note: Knowledge, Attitude, and Prostate Cancer-Screening Experience Among African American Men in Southside Chicago: Intervention Strategy for Risk Reduction Activities. J Racial Ethnic Health Dispar 2015;2(3):422–22.

29. Mahalik JR, Burns SM, Syzdek M. Masculinity and perceived normative health behaviors as predictors of men’s health behaviors. Soc Sci Med 2007;64:2201–209.

30. Meissner HI, Breen N, Klabunde CN, et al. Patterns of colorectal cancer screening uptake among men and women in the United States. Cancer Epidemiol Prevent Biomark 2006;15(2):389–94.

31. American Cancer Society. American Cancer Society Guidelines for the Early Detection of Cancer. 2017. Available at: https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html.

32. Ford ME, Vernon SW, Havstad SL, et al. Factors influ-encing behavioral intention regarding prostate cancer screening among older African-American men. J Nat Med Assoc 2006;98(4):505–14.