Journal of Racial and Ethnic Health Disparities

, Volume 5, Issue 6, pp 1273–1283 | Cite as

Racial and Ethnic Differences in Prostate Cancer Survivors’ Perceived Engagement in Treatment Decision-Making

  • Nynikka R. Palmer
  • Steven E. Gregorich
  • Jennifer Livaudais-Toman
  • Jane Jih
  • Celia P. Kaplan



We examined prostate cancer patients’ perceived engagement in treatment decision-making and associated factors by race/ethnicity in a multiethnic sample.


We identified patients through the California Cancer Registry. Patients completed a cross-sectional telephone interview in English, Spanish, Cantonese, or Mandarin. Multivariable logistic regression models, stratified by race/ethnicity, estimated the associations of patient demographic and health status characteristics on (1) doctor asked patient to help decide treatment plan and (2) patient and doctor worked out a treatment plan together.


We included 855 prostate cancer patients: African American (19%), Asian American (15%), Latino (24%), and White (42%). Asian American patients were less likely than White patients to report that their doctors asked them to help decide a treatment plan (OR = 0.31; 95% CI = 0.18–0.53) and that they worked out a treatment plan with their doctors (OR = 0.54; 95% CI = 0.33–0.90). Language of interview was a significant contributing factor in stratified analysis for both outcomes.


Asian American prostate cancer patients reported less engagement in treatment decision-making, with Chinese language being a significant contributing factor. Future research should identify patient-centered strategies that effectively engage underserved patients and support healthcare providers in shared decision-making with multiethnic and multilingual patients.


Prostate cancer Treatment decision-making Disparities Men Engagement 


Compliance with Ethical Standards

All study activities were approved by the University of California, San Francisco Institutional Review Board.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© W. Montague Cobb-NMA Health Institute 2018

Authors and Affiliations

  • Nynikka R. Palmer
    • 1
  • Steven E. Gregorich
    • 2
  • Jennifer Livaudais-Toman
    • 2
  • Jane Jih
    • 2
  • Celia P. Kaplan
    • 2
  1. 1.Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, Department of MedicineUniversity of CaliforniaSan FranciscoUSA
  2. 2.Division of General Internal Medicine, Department of MedicineUniversity of California San FranciscoSan FranciscoUSA

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