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

J Racial Ethn Health Disparities. 2018 Dec;5(6):1273-1283. doi: 10.1007/s40615-018-0475-0. Epub 2018 Mar 7.


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: Disparities; Engagement; Men; Prostate cancer; Treatment decision-making.

MeSH terms

  • Adult
  • African Americans
  • Aged
  • Asian Americans
  • Cancer Survivors*
  • Cross-Sectional Studies
  • Decision Making
  • Ethnic Groups*
  • European Continental Ancestry Group
  • Healthcare Disparities / ethnology*
  • Hispanic Americans
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Participation*
  • Prostatic Neoplasms / therapy*