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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
Article

Abstract

Objective

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

Method

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.

Results

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.

Conclusion

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.

Keywords

Prostate cancer Treatment decision-making Disparities Men Engagement 

Notes

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.

References

  1. 1.
    Hamdy FC, Donovan JL, Lane JA, Mason M, Metcalfe C, Holding P, et al. 10-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. N Engl J Med. 2016;375:1415–24.CrossRefPubMedGoogle Scholar
  2. 2.
    Boorjian SA, Karnes RJ, Viterbo R, Rangel LJ, Bergstralh EJ, Horwitz EM, et al. Long-term survival after radical prostatectomy versus external-beam radiotherapy for patients with high-risk prostate cancer. Cancer. 2011;117:2883–91.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Eisemann N, Nolte S, Schnoor M, Katalinic A, Rohde V, Waldmann A. The ProCaSP study: quality of life outcomes of prostate cancer patients after radiotherapy or radical prostatectomy in a cohort study. BMC Urol. 2015;15:28.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Barocas DA, Grubb R, Black A, Penson DF, Fowke JH, Andriole G, et al. Association between race and follow-up diagnostic care after a positive prostate cancer screening test in the Prostate, Lung, Colorectal, and Ovarian cancer screening trial. Cancer. 2013;119:2223–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Chen RC, Basak R, Meyer A, Kuo T, Carpenter WR, Agans RP, et al. Association between choice of radical prostatectomy, external beam radiotherapy, brachytherapy, or active surveillance and patient-reported quality of life among men with localized prostate cancer. JAMA. 2017;317:1141–50.CrossRefPubMedGoogle Scholar
  6. 6.
    Daum LM, Reamer EN, Ruterbusch JJ, Liu U, Holmes-Rovner M, Xu J. Patient knowledge and qualities of treatment decisions for localized prostate cancer. J Am Board Fam Med. 2017;30:288–97.CrossRefPubMedGoogle Scholar
  7. 7.
    Mallapreddi A, Ruterbusch J, Reamer E, Eggly S, Xu J. Active surveillance for low-risk localized prostate cancer: what do men and their partners think? Fam Pract. 2017;34:90–7.CrossRefGoogle Scholar
  8. 8.
    Xu J, Neale AV, Dailey RK, Eggly S, Schwartz KL. Patient perspective on watchful waiting/active surveillance for localized prostate cancer. J Am Board Fam Med. 2012;25:763–70.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Johansson E, Steineck G, Holmberg L, Johansson J, Nyberg T, Ruutu M, et al. Long-term quality-of-life outcomes after radical prostatectomy or watchful waiting: the Scandinavian Prostate Cancer Group-4 randomised trial. Lancet Oncol. 2011;12(9):891–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Epstein RM, Street RL. Patient-centered communication in cancer care: promoting health and reducing suffering. Bethesda: National Cancer Institute; 2007.Google Scholar
  11. 11.
    Katz SJ, Belkora J, Elwyn G. Shared decision making for treatment of cancer: challenges and opportunities. J Oncol Pract. 2014;10:206–8.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Edwards A, Elwyn G. Inside the black box of shared decision making: distinguishing between the process of involvement and who makes the decision. Health Expect. 2006;9:307–20.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Griffin SJ, Kinmonth AL, Veltman MWM, Gillard S, Grant J, Stewart M. Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. Ann Fam Med. 2004;2:595–608.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Hopmans W, Damman OC, Senan S, Hartemink KJ, Smit EF, Timmermans DRM. A patient perspective on shared decision making in stage I non-small cell lung cancer: a mixed methods study. BMC Cancer. 2015;15:959.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Savelberg W, Moser A, Smidt M, Boersma L, Haekens C, van der Weijden T. Protocol for a pre-implementation and post-implementation study on shared decision-making in the surgical treatment of women with early-stage breast cancer. BMJ. 2015;5:e007698.CrossRefGoogle Scholar
  16. 16.
    Stacey D, Samant R, Bennett C. Decision making in oncology: a review of patient decision aids to support patient participation. CA Cancer J Clin. 2008;58:293–304.CrossRefPubMedGoogle Scholar
  17. 17.
    Bieber C, Nicolai J, Gschwendtner K, Muller N, Reuter K, Buchholz A, et al. How does a shared decision-making (SDM) intervention for oncologists affect participation style and preference matching in patients with breast and colon cancer? J Cancer Educ. 2016.  https://doi.org/10.1007/s13187-016-1146-7.
  18. 18.
    Gattellari M, Butow PN, Tattersall MH. Sharing decisions in cancer care. Soc Sci Med. 2001;52:1865–78.CrossRefPubMedGoogle Scholar
  19. 19.
    Keating NL, Guadagnoli E, Landrum MB, Borbas C, Weeks JC. Treatment decision making in early-stage breast cancer: should surgeons match patients’ desired level of involvement? J Clin Oncol. 2002;20:1473–9.PubMedGoogle Scholar
  20. 20.
    Shay LA, Lafata JE. Where is the evidence? A systematic review of shared decision making and patient outcomes. Med Decis Mak. 2015;35:114–31.CrossRefGoogle Scholar
  21. 21.
    Carrion IV, Nedjat-Haiem FR, Marquez DX. Examining cultural factors that influence treatment decisions: a pilot study of Latino men with cancer. J Cancer Educ. 2013;28:729–37.CrossRefPubMedGoogle Scholar
  22. 22.
    Hosain GMM, Sanderson M, Du XL, Chan W, Strom SS. Racial/ethnic differences in treatment discussed, preferred, and received for prostate cancer in a tri-ethnic population. Am J Mens Health. 2012;6:249–57.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    McFall SL, Mullen PD, Byrd TL, Cantor SB, Le Y, Torres-Vigil I, et al. Treatment decisions for localized prostate cancer: a concept mapping approach. Health Expect. 2015;18:2079–90.CrossRefPubMedGoogle Scholar
  24. 24.
    Xu J, Janisse J, Ruterbusch JJ, Ager J, Liu J, Holmes-Rovner M, et al. Patients' survival expectations with and without their chosen treatment for prostate cancer. Ann Fam Med. 2016;14:208–14.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Chewning B, Bylund CL, Shah B, Arora NK, Gueguen JA, Makoul G. Patient preferences for shared decisions: a systematic review. Patient Educ Couns. 2012;86:9–18.CrossRefPubMedGoogle Scholar
  26. 26.
    Ratanawongsa N, Zikmund-Fisher BJ, Couper MP, Van Hoewyk J, Powe NR. Race, ethnicity, and shared decision making for hyperlipidemia and hypertension treatment: the DECISIONS survey. Med Decis Mak. 2010;30:65S–76S.CrossRefGoogle Scholar
  27. 27.
    Kaplan CP, Napoles AM, Narine S, Gregorich S, Livaudais-Toman J, Nguyen T, et al. Knowledge and attitudes regarding clinical trials and willingness to participate among prostate cancer patients. Contemp Clin Trials. 2015;45:443–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Chew LD, Griffin JM, Partin MR, Noorbaloochi S, Grill JP, Snyder A, et al. Validation of screening questions for limited health literacy in a large VA outpatient population. J Gen Intern Med. 2008;23:561–6.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Katz JN, Chang LC, Sangha O, Fossel AH, Bates DW. Can comorbidity be measured by questionnaire rather than medical record review? Med Care. 1996;34:73–84.CrossRefPubMedGoogle Scholar
  30. 30.
    Gleason DF, Mellinger GT, Veterans Administration Cooperative Urological Research Group. Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging. 1974. J Urol. 2002;167:953–8.CrossRefPubMedGoogle Scholar
  31. 31.
    Glass AS, Cooperberg MR, Meng MV, Carroll PR. Role of active surveillance in the management of localized prostate cancer. J Natl Cancer Inst Monogr. 2012;2012:202–6.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Mead EL, Doorenbos AZ, Javid SH, Haozous EA, Alvord LA, Flum DR, et al. Shared decision-making for cancer care among racial and ethnic minorities: a systematic review. Am J Public Health. 2013;103:e15–29.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    El Turabi A, Abel GA, Roland M, Lyratzopoulos G. Variation in reported experience of involvement in cancer treatment decision making: evidence from the National Cancer Patient Experience Survey. Br J Cancer. 2013;109:780–7.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Kraetschmer N, Sharpe N, Urowitz S, Deber RB. How does trust affect patient preferences for participation in decision-making? Health Expect. 2004;7:317–26.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Lovell BL, Lee RT, Brotheridge CM. Physician communication: barriers to achieving shared understanding and shared decision making with patients. J Particip Med. 2010;2:e12.Google Scholar
  36. 36.
    Katie Lee SYC, Knobf MT. Primary breast cancer decision-making among Chinese American women: satisfaction, regret. Nurs Res. 2015;64:391–401.CrossRefPubMedGoogle Scholar
  37. 37.
    Lee S, Chen L, Ma GX, Fang CY. What is lacking in patient-physician communication: perspectives from Asian American breast cancer patients and oncologists. J Behav Health. 2012;1:102.CrossRefGoogle Scholar
  38. 38.
    Wong ST, Chen W, Bottorff JL, Hislop TG. Treatment decision making among Chinese women with DCIS. J Psychosoc Oncol. 2008;26:53–73.CrossRefPubMedGoogle Scholar
  39. 39.
    Gomez SL, Noone A, Lichtensztajn D, Scoppa S, Gibson JT, Liu L, et al. Cancer incidence trends among Asian American populations in the United States, 1990-2008. J Natl Cancer Inst. 2013;105:1096–110.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Nishita C, Browne C. Advancing research in transitional care: challenges of culture, language and health literacy in Asian American and native Hawaiian elders. J Health Care Poor Underserved. 2013;24:404–18.CrossRefPubMedGoogle Scholar
  41. 41.
    Pew Research Center. The rise of Asian Americans. Washington, D.C.: Pew Research Center; 2013.Google Scholar
  42. 42.
    Lee SK, Knobf MT. Family involvement for breast cancer decision making among Chinese-American women. Psychooncology. 2016;25:1493–9.CrossRefPubMedGoogle Scholar
  43. 43.
    Su CT, McMahan RD, Williams BA, Sharma RK, Sudore RL. Family matters: effects of birth order, culture, and family dynamics on surrogate decision-making. J Am Geriatr Soc. 2014;62:175–82.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Kwok C, Koo FK. Participation in treatment decision-making among Chinese-Australian women with breast cancer. Support Care Cancer. 2017;25:957–63.CrossRefPubMedGoogle Scholar
  45. 45.
    Davison BJ, Breckon E. Factors influencing treatment decision making and information preferences of prostate cancer patients on active surveillance. Patient Educ Couns. 2012;87:369–74.CrossRefPubMedGoogle Scholar
  46. 46.
    Hoffman KE. Management of older men with clinically localized prostate cancer: the significance of advanced age and comorbidity. Semin Radiat Oncol. 2012;22:284–94.CrossRefPubMedGoogle Scholar
  47. 47.
    Sajid S, Mohile SG, Szmulewitz R, Posadas E, Dale W. Individualized decision-making for older men with prostate cancer: balancing cancer control with treatment consequences across the clinical spectrum. Semin Oncol. 2011;38:309–25.CrossRefPubMedGoogle Scholar
  48. 48.
    American Cancer Society. Cancer facts and figures for African Americans 2016-2018. Atlanta: American Cancer Society; 2016.Google Scholar
  49. 49.
    Amalraj S, Starkweather C, Nguyen C, Naeim A. Health literacy, communication, and treatment decision-making in older cancer patients. Oncology (Williston Park). 2009;23:369–75.Google Scholar
  50. 50.
    Song L, Tatum K, Greene G, Chen RC. eHealth Literacy and Partner involvement in treatment decision making for men with newly diagnosed localized prostate cancer. Oncol Nurs Forum. 2017;44:225–33.PubMedGoogle Scholar
  51. 51.
    Joosten EA, DeFuentes-Merillas L, de Weert GH, Sensky T, van der Staak CP, de Jong CA. Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status. Psychother Psychosom. 2008;77:219–26.CrossRefPubMedGoogle Scholar
  52. 52.
    Chan ECY, McFall SL, Byrd TL, Mullen PD, Volk RJ, Ureda J, et al. A community-based intervention to promote informed decision making for prostate cancer screening among Hispanic American men changed knowledge and role preferences: a cluster RCT. Patient Educ Couns. 2011;84:e44–51.CrossRefPubMedGoogle Scholar
  53. 53.
    Williams SW, Hanson LC, Boyd C, Green M, Goldmon M, Wright G, et al. Communication, decision making, and cancer: what African Americans want physicians to know. J Palliat Med. 2008;11:1221–6.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Katz JN, Lyons N, Wolff LS, Silverman J, Emrani P, Holt HL, et al. Medical decision-making among Hispanics and non-Hispanic Whites with chronic back and knee pain: a qualitative study. BMC Musculoskelet Disord. 2011;12:78.CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    Kreling B, Figueiredo MI, Sheppard VL, Mandelblatt JS. A qualitative study of factors affecting chemotherapy use in older women with breast cancer: barriers, promoters, and implications for intervention. Psychooncology. 2006;15:1065–76.CrossRefPubMedGoogle Scholar
  56. 56.
    Denis L, Joniau S, Bossi A, Baskin-Bey E, Fitzpatrick JM. PCA: prostate cancer, patient-centred approach or both? BJU Int. 2012;110:16–22.CrossRefPubMedGoogle Scholar
  57. 57.
    Kehl KL, Landrum MB, Arora NK, Ganz PA, van Ryn M, Mack JW, et al. Association of actual and preferred decision roles with patient-reported quality of care: shared decision making in cancer care. JAMA Oncol. 2015;1:50–8.CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Murray-García JL, Selby JV, Schmittdiel J, Grumbach K, Quesenberry CP. Racial and ethnic differences in a patient survey: patients’ values, ratings, and reports regarding physician primary care performance in a large health maintenance organization. Med Care. 2000;38:300–10.CrossRefPubMedGoogle Scholar
  59. 59.
    Kane HL, Halpern MT, Squiers LB, Treiman KA, McCormack LA. Implementing and evaluating shared decision making in oncology practice. CA Cancer J Clin. 2014;64:377–88.CrossRefPubMedGoogle Scholar
  60. 60.
    Karliner LS, Jacobs EA, Chen AH, Mutha S. Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Serv Res. 2007;42:727–54.CrossRefPubMedPubMedCentralGoogle Scholar

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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