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Social and clinical predictors of prostate cancer treatment decisions among men in South Carolina

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Abstract

Objective

To assess social and clinical influences of prostate cancer treatment decisions among white and black men in the Midlands of South Carolina.

Methods

We linked data collected on treatment decision making in men diagnosed with prostate cancer from 1996 through 2002 with clinical and sociodemographic factors collected routinely by the South Carolina Central Cancer Registry (SCCCR). Unconditional logistic regression was used to assess social and clinical influences on treatment decision.

Results

A total of 435 men were evaluated. Men of both races who chose surgery (versus radiation) were more likely to be influenced by their physician and by family/friends. Black men who chose surgery also were ~5 times more likely to make independent decisions (i.e., rather than be influenced by their doctor). White men who chose surgery were twice as likely to be influenced by the desire for cure and less likely to consider the side effects of impotence (odds ratio (OR) = 0.40; 95% confidence interval (CI): 0.18, 0.88) and incontinence (OR = 0.27; 95% CI: 0.12, 0.63); by contrast, there was a suggestion of an opposite effect in black men, whose decision regarding surgery tended to be more strongly influenced by these side effects.

Conclusion

Results suggest that both clinical and social predictors play an important role for men in choosing a prostate cancer treatment, but these influences may differ by race.

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Abbreviations

CI:

Confidence interval

OR:

Odds ratio

PSA:

Prostate-specific antigen

SCCCR:

South Carolina Central Cancer Registry

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Acknowledgments

This work was supported, in part, by grant number 1 U01 CA114601 from the National Cancer Institute, Center to Reduce Cancer Health Disparities (Community Networks Program) to the South Carolina Cancer Disparities Community Network. Dr. Wagner is currently funded by a grant from the Georgia Cancer Coalition (Proposal number 038505). Dr. Hébert is supported by an Established Investigator Award in Cancer Prevention and Control from the Cancer Training Branch of the National Cancer Institute (K05 CA136975). Dr. Drake is supported by PC081669 from the Department of Defense.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, College of Public Health, Paul D. Coverdell Center for Biomedical and Health Sciences, University of Georgia, 500 D.W. Brooks Drive, Athens, GA, 30602-7396, USA

    Sara E. Wagner

  2. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Bettina F. Drake

  3. Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA

    Bettina F. Drake

  4. School of Public Health, Department of Health Management and Policy, Saint Louis University, St. Louis, MO, USA

    Keith Elder

  5. Arnold School of Public Health, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA

    James R. Hébert

  6. South Carolina Statewide Cancer Prevention and Control Program, Columbia, SC, USA

    James R. Hébert

Authors
  1. Sara E. Wagner
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  2. Bettina F. Drake
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  3. Keith Elder
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  4. James R. Hébert
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Correspondence to Sara E. Wagner.

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Wagner, S.E., Drake, B.F., Elder, K. et al. Social and clinical predictors of prostate cancer treatment decisions among men in South Carolina. Cancer Causes Control 22, 1597–1606 (2011). https://doi.org/10.1007/s10552-011-9836-2

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  • DOI: https://doi.org/10.1007/s10552-011-9836-2

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