Physician patient communication and treatment decision making: 'Analyzing the gap' for Black and White prostate cancer patients

In the United States, the death rate from prostate cancer is 2.4 times higher in African American men than in white men. Several factors have been linked with an increased risk for prostate cancer, including age, race, family history, race/ethnicity, and diet. However, studies have shown that cancer patients are faced with very difficult decisions regarding treatment.;Since treatment may produce no real benefits, electing to treat may have a detrimental impact on subsequent quality of life. Treatment options carry risk of significant morbidity or even death. In order to make the best decision the physician patient communication process must adequately prepare the patient.;This study evaluated the physician patient communication and treatment decision making differences between black and white prostate cancer patients treated in the state of Alabama. Univariate and bivariate analysis of the data was performed to describe the data, identify any potential problems, and identify any differences between the two groups of men. Multivariable analyses, more specifically regression analyses, controlled for the effects of any confounding variables. An Autonomy Preference Index (API) was measured from 0 to l.;White men were almost two times more likely to independently seek information (p = .043). White men were almost four times more likely to use the Internet to seek information (p = .048). Only three-quarters of black men reported receiving information on the side effects of treatment, compared to more than 80% of white patients. White men were also more than three times more likely to receive information on watchful waiting as a treatment option for prostate cancer (p = .001). Almost 70% of white men reported actively making the treatment decision with their physician, compared to only 54% of black men. The mean API score for black men was significantly different from the API score for white men (p = 0.001).;Race is influential in predicting the experience a patient will have in the physician patient communication process for prostate cancer treatment.