Racial differences in trust and regular source of patient care and the implications for prostate cancer screening use

William R. Carpenter, Paul A. Godley, Jack A. Clark, James A. Talcott, Timothy Finnegan, Merle Mishel, Jeannette Bensen, Walter Rayford, L. Joseph Su, Elizabeth T.H. Fontham, James L. Mohler

Research output: Contribution to journalArticlepeer-review

82 Scopus citations

Abstract

BACKGROUND: Nonmedical factors may modify the biological risk of prostate cancer (PCa) and contribute to the differential use of early detection; curative care; and, ultimately, greater racial disparities in PCa mortality. In this study, the authors examined patients' usual source of care, continuity of care, and mistrust of physicians and their association with racial differences in PCa screening. METHODS: Study nurses conducted in-home interviews of 1031 African-American men and Caucasian-American men aged ≥50 years in North Carolina and Louisiana within weeks of their PCa diagnosis. Medical records were abstracted, and the data were used to conduct bivariate and multivariate analyses. RESULTS: Compared with African Americans, Caucasian Americans exhibited higher physician trust scores and a greater likelihood of reporting a physician office as their usual source of care, seeing the same physician at regular medical encounters, and historically using any PCa screening. Seeing the same physician for regular care was associated with greater trust and screening use. Men who reported their usual source of care as a physician office, hospital clinic, or Veterans Administration facility were more likely to report prior PCa screening than other men. In multivariate regression analysis, seeing the same provider remained associated with prior screening use, whereas both race and trust lost their association with prior screening. CONCLUSIONS: The current results indicated that systems factors, including those that differ among different sources of care and those associated with the continuity of care, may provide tangible targets to address disparities in the use of PCa early detection, may attenuate racial differences in PCa screening use, and may contribute to reduced racial disparities in PCa mortality.

Original languageEnglish (US)
Pages (from-to)5048-5059
Number of pages12
JournalCancer
Volume115
Issue number21
DOIs
StatePublished - Nov 1 2009
Externally publishedYes

Keywords

  • African American
  • Caucasian American
  • Continuity of care
  • Physician mistrust
  • Prostate cancer
  • Screening
  • Source of care

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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