Cancer Causes & Control

, Volume 21, Issue 1, pp 31–40 | Cite as

Race, healthcare access and physician trust among prostate cancer patients

  • Young Kyung Do
  • William R. Carpenter
  • Pamela Spain
  • Jack A. Clark
  • Robert J. Hamilton
  • Joseph A. Galanko
  • Anne Jackman
  • James A. Talcott
  • Paul A. Godley
Original Paper

Abstract

Objective

To study the effect of healthcare access and other characteristics on physician trust among black and white prostate cancer patients.

Methods

A three-timepoint follow-up telephone survey after cancer diagnosis was conducted. This study analyzed data on 474 patients and their 1,320 interviews over three time periods.

Results

Among other subpopulations, black patients who delayed seeking care had physician trust levels that were far lower than that of both Caucasians as well as that of the black patients overall. Black patients had greater variability in their levels of physician trust compared to their white counterparts.

Conclusions

Both race and access are important in explaining overall lower levels and greater variability in physician trust among black prostate cancer patients. Access barriers among black patients may spill over to the clinical encounter in the form of less physician trust, potentially contributing to racial disparities in treatment received and subsequent outcomes. Policy efforts to address the racial disparities in prostate cancer should prioritize improving healthcare access among minority groups.

Keywords

Race Disparity Prostate neoplasm Healthcare utilization Trust 

References

  1. 1.
    American Cancer Society (2007) Cancer facts & figures 2007. American Cancer Society, Atlanta, GAGoogle Scholar
  2. 2.
    Gilligan T (2005) Social disparities and prostate cancer: mapping the gaps in our knowledge. Cancer Causes Control 16:45–53CrossRefPubMedGoogle Scholar
  3. 3.
    Gilligan T, Wang PS, Levin R, Kantoff PW, Avorn J (2004) Racial differences in screening for prostate cancer in the elderly. Arch Intern Med 164:1858–1864CrossRefPubMedGoogle Scholar
  4. 4.
    Etzioni R, Berry KM, Legler JM, Shaw P (2002) Prostate-specific antigen testing in black and white men: an analysis of Medicare claims from 1991–1998. Urology 59:251–255CrossRefPubMedGoogle Scholar
  5. 5.
    Hoffman RM, Gilliland FD, Eley JW et al (2001) Racial and ethnic differences in advanced-stage prostate cancer: the Prostate Cancer Outcomes Study. J Natl Cancer Inst 93:388–395CrossRefPubMedGoogle Scholar
  6. 6.
    Polednak AP, Flannery JT (1992) Black versus white racial differences in clinical stage at diagnosis and treatment of prostatic cancer in Connecticut. Cancer 70:2152–2158CrossRefPubMedGoogle Scholar
  7. 7.
    Roetzheim RG, Pal N, Tennant C et al (1999) Effects of health insurance and race on early detection of cancer. J Natl Cancer Inst 91:1409–1415CrossRefPubMedGoogle Scholar
  8. 8.
    Merrill RM, Lyon JL (2000) Explaining the difference in prostate cancer mortality rates between white and black men in the United States. Urology 55:730–735CrossRefPubMedGoogle Scholar
  9. 9.
    Vijayakumar S, Weichselbaum R, Vaida F, Dale W, Hellman S (1996) Prostate-specific antigen levels in African-Americans correlate with insurance status as an indicator of socioeconomic status. Cancer J Sci Am 2:225–233PubMedGoogle Scholar
  10. 10.
    Moul JW, Sesterhenn IA, Connelly RR et al (1995) Prostate-specific antigen values at the time of prostate cancer diagnosis in African-American men. JAMA 274:1277–1281CrossRefPubMedGoogle Scholar
  11. 11.
    Polednak AP (2002) Black-white differences in tumor grade (aggressiveness) at diagnosis of prostate cancer, 1992–1998. Ethn Dis 12:536–540PubMedGoogle Scholar
  12. 12.
    Fowler JE Jr, Bigler SA, Bowman G, Kilambi NK (2000) Race and cause specific survival with prostate cancer: influence of clinical stage, Gleason score, age and treatment. J Urol 163:137–142CrossRefPubMedGoogle Scholar
  13. 13.
    Rose AJ, Backus BM, Gershman ST, Santos P, Ash AS, Battaglia TA (2007) Predictors of aggressive therapy for nonmetastatic prostate carcinoma in Massachusetts from 1998 to 2002. Med Care 45:440–447CrossRefPubMedGoogle Scholar
  14. 14.
    Zeliadt SB, Potosky AL, Etzioni R, Ramsey SD, Penson DF (2004) Racial disparity in primary and adjuvant treatment for nonmetastatic prostate cancer: SEER-Medicare trends 1991 to 1999. Urology 64:1171–1176CrossRefPubMedGoogle Scholar
  15. 15.
    Shavers VL, Brown ML, Potosky AL et al (2004) Race/ethnicity and the receipt of watchful waiting for the initial management of prostate cancer. J Gen Intern Med 19:146–155CrossRefPubMedGoogle Scholar
  16. 16.
    Harlan LC, Potosky A, Gilliland FD et al (2001) Factors associated with initial therapy for clinically localized prostate cancer: prostate cancer outcomes study. J Natl Cancer Inst 93:1864–1871CrossRefPubMedGoogle Scholar
  17. 17.
    Klabunde CN, Potosky AL, Harlan LC, Davis WW, Potosky AL (1998) Trends and black/white differences in treatment for nonmetastatic prostate cancer. Med Care 36:1337–1348CrossRefPubMedGoogle Scholar
  18. 18.
    Schapira MM, McAuliffe TL, Nattinger AB (1995) Treatment of localized prostate cancer in African-American compared with Caucasian men. Less use of aggressive therapy for comparable disease. Med Care 33:1079–1088CrossRefPubMedGoogle Scholar
  19. 19.
    Zeliadt SB, Penson DF, Albertsen PC, Concato J, Etzioni RD (2003) Race independently predicts prostate specific antigen testing frequency following a prostate carcinoma diagnosis. Cancer 98:496–503CrossRefPubMedGoogle Scholar
  20. 20.
    Shavers VL, Brown M, Klabunde CN et al (2004) Race/ethnicity and the intensity of medical monitoring under ‘watchful waiting’ for prostate cancer. Med Care 42:239–250CrossRefPubMedGoogle Scholar
  21. 21.
    Cohen JH, Schoenbach VJ, Kaufman JS et al (2006) Racial differences in clinical progression among Medicare recipients after treatment for localized prostate cancer (United States). Cancer Causes Control 17:803–811CrossRefPubMedGoogle Scholar
  22. 22.
    Godley PA, Schenck AP, Amamoo MA et al (2003) Racial differences in mortality among Medicare recipients after treatment for localized prostate cancer. J Natl Cancer Inst 95:1702–1710PubMedGoogle Scholar
  23. 23.
    Allen JD, Kennedy M, Wilson-Glover A, Gilligan TD (2007) African-American men’s perceptions about prostate cancer: implications for designing educational interventions. Soc Sci Med 64:2189–2200CrossRefPubMedGoogle Scholar
  24. 24.
    Myers RE, Daskalakis C, Cocroft J et al (2005) Preparing African-American men in community primary care practices to decide whether or not to have prostate cancer screening. J Natl Med Assoc 97:1143–1154PubMedGoogle Scholar
  25. 25.
    Institute of Medicine (IOM) (2003) Unequal treatment: confronting racial and ethnic disparities in healthcare. The National Academies Press, Washington, DCGoogle Scholar
  26. 26.
    Steele CB, Miller DS, Maylahn C, Uhler RJ, Baker CT (2000) Knowledge, attitudes, and screening practices among older men regarding prostate cancer. Am J Public Health 90:1595–1600CrossRefPubMedGoogle Scholar
  27. 27.
    Demark-Wahnefried W, Strigo T, Catoe K et al (1995) Knowledge, beliefs, and prior screening behavior among blacks and whites reporting for prostate cancer screening. Urology 46:346–351CrossRefPubMedGoogle Scholar
  28. 28.
    Talcott JA, Spain P, Clark JA et al (2007) Hidden barriers between knowledge and behavior: the North Carolina prostate cancer screening and treatment experience. Cancer 109:1599–1606CrossRefPubMedGoogle Scholar
  29. 29.
    Beskow LM, Millikan RC, Sandler RS, Godley PA, Weiner BJ, Weinberger M (2006) The effect of physician permission versus notification on research recruitment through cancer registries. Cancer Causes Control 17:315–323CrossRefPubMedGoogle Scholar
  30. 30.
    Safran DG, Kosinski M, Tarlov AR et al (1998) The Primary Care Assessment Survey: tests of data quality and measurement performance. Med Care 36:728–739CrossRefPubMedGoogle Scholar
  31. 31.
    Kilbourne AM, Switzer G, Hyman K, Crowley-Matoka M, Fine MJ (2006) Advancing health disparities research within the health care system: a conceptual framework. Am J Public Health 96:2113–2121CrossRefPubMedGoogle Scholar
  32. 32.
    LaVeist TA (1994) Beyond dummy variables and sample selection: what health services researchers ought to know about race as a variable. Health Serv Res 29:1–16PubMedGoogle Scholar
  33. 33.
    Kennedy P (2003) A guide to econometrics. The MIT Press, Cambridge, MAGoogle Scholar
  34. 34.
    Taira DA, Safran DG, Seto TB et al (2001) Do patient assessments of primary care differ by patient ethnicity? Health Serv Res 36:1059–1071PubMedGoogle Scholar
  35. 35.
    Safran DG (2003) Measuring the quality of the primary care relationship. In: Dube L, Ferland G, Moskowitz, DS (eds) Emotional and interpersonal dimensions of health services, Chap 2. McGill-Queens University Press, New York, pp 12–44Google Scholar
  36. 36.
    AHRQ (2006) Access to care. National Healthcare Disparities Report, Chap 3. Rockville, MD, U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality; December 2006. AHRQ Pub. No. 07-0012Google Scholar
  37. 37.
    Andersen RM, Davidson PL (2007) Improving access to care in America. In: Andersen RM, Rice TH, Kominski GF (eds) Changing the U.S. health care system, Chap 1. Jossey-Bass, San Francisco, pp 3–31Google Scholar
  38. 38.
    Karpati A, Galea S, Awerbuch T, Levins R (2002) Variability and vulnerability at the ecological level: implications for understanding the social determinants of health. Am J Public Health 92:1768–1772CrossRefPubMedGoogle Scholar
  39. 39.
    Levins R, Lopez C (1999) Toward an ecosocial view of health. Int J Health Serv 29:261–293CrossRefPubMedGoogle Scholar
  40. 40.
    Eden J, Simone JV (2005) Assessing the quality of cancer care: an approach to measurement in Georgia. The National Academies Press, Washington, DCGoogle Scholar
  41. 41.
    Schulman KA, Seils DM (2003) Outcomes research in oncology: improving patients’ experiences with cancer treatment. Clin Ther 25:665–670CrossRefPubMedGoogle Scholar
  42. 42.
    Ganz PA (2002) What outcomes matter to patients: a physician-researcher point of view. Med Care 40:III11–III19CrossRefPubMedGoogle Scholar
  43. 43.
    Cleary PD, Edgman-Levitan S (1997) Health care quality. Incorporating consumer perspectives. JAMA 278:1608–1612CrossRefPubMedGoogle Scholar
  44. 44.
    Stewart AL, Napoles-Springer AM, Gregorich SE et al (2007) Interpersonal processes of care survey: patient-reported measures for diverse groups. Health Serv Res 42:1235–1256CrossRefPubMedGoogle Scholar
  45. 45.
    Jayadevappa R, Chhatre S, Whittington R, Bloom BS, Wein AJ, Malkowicz SB (2006) Health-related quality of life and satisfaction with care among older men treated for prostate cancer with either radical prostatectomy or external beam radiation therapy. BJU Int 97:955–962CrossRefPubMedGoogle Scholar
  46. 46.
    Talcott JA, Manola J, Clark JA et al (2003) Time course and predictors of symptoms after primary prostate cancer therapy. J Clin Oncol 21:3979–3986CrossRefPubMedGoogle Scholar
  47. 47.
    Hoffman RM, Hunt WC, Gilliland FD, Stephenson RA, Potosky AL (2003) Patient satisfaction with treatment decisions for clinically localized prostate carcinoma. Results from the Prostate Cancer Outcomes Study. Cancer 97:1653–1662CrossRefPubMedGoogle Scholar
  48. 48.
    Clark JA, Inui TS, Silliman RA et al (2003) Patients’ perceptions of quality of life after treatment for early prostate cancer. J Clin Oncol 21:3777–3784CrossRefPubMedGoogle Scholar
  49. 49.
    Potosky AL, Reeve BB, Clegg LX et al (2002) Quality of life following localized prostate cancer treated initially with androgen deprivation therapy or no therapy. J Natl Cancer Inst 94:430–437PubMedGoogle Scholar
  50. 50.
    Eton DT, Lepore SJ, Helgeson VS (2001) Early quality of life in patients with localized prostate carcinoma: an examination of treatment-related, demographic, and psychosocial factors. Cancer 92:1451–1459CrossRefPubMedGoogle Scholar
  51. 51.
    Stanford JL, Feng Z, Hamilton AS et al (2000) Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA 283:354–360CrossRefPubMedGoogle Scholar
  52. 52.
    Clark JA, Wray N, Brody B, Ashton C, Giesler B, Watkins H (1997) Dimensions of quality of life expressed by men treated for metastatic prostate cancer. Soc Sci Med 45:1299–1309CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Young Kyung Do
    • 1
    • 2
  • William R. Carpenter
    • 1
    • 3
    • 4
  • Pamela Spain
    • 4
  • Jack A. Clark
    • 5
    • 6
  • Robert J. Hamilton
    • 7
  • Joseph A. Galanko
    • 8
  • Anne Jackman
    • 4
  • James A. Talcott
    • 9
  • Paul A. Godley
    • 3
    • 4
    • 8
    • 10
  1. 1.Department of Health Policy and ManagementUniversity of North Carolina at Chapel Hill Gillings School of Global Public HealthChapel HillUSA
  2. 2.Program in Health Services and Systems ResearchDuke-NUS Graduate Medical School SingaporeSingaporeSingapore
  3. 3.UNC-Lineberger Comprehensive Cancer CenterChapel HillUSA
  4. 4.UNC Cecil G. Sheps Center for Health Services ResearchChapel HillUSA
  5. 5.Center for Health Quality, Outcomes, and Economic ResearchEdith Nourse Rogers Memorial Veterans HospitalBedfordUSA
  6. 6.Boston University School of Public HealthBostonUSA
  7. 7.Department of Surgery (Urology)University of TorontoTorontoCanada
  8. 8.UNC Department of Medicine, School of MedicineChapel HillUSA
  9. 9.Center for Outcomes ResearchMassachusetts General Hospital Cancer Center and Harvard Medical SchoolBostonUSA
  10. 10.UNC Gillings School of Global Public HealthChapel HillUSA

Personalised recommendations