Moderators of Prostate Cancer Testing Intention and PSA Testing in Black Men

Abstract

Black men have the highest burden of prostate cancer (PCa) compared to all other races. Early detection of PCa is controversial, thus preference based PCa testing is recommended. PCa testing intention can be used as a proxy for testing preferences. Intention is known to predict behavior; however there is a gap between testing intention and testing behavior. The aims of this study were to examine the PCa testing intention-prostate specific antigen (PSA) testing gap and identify social cognitive variables that moderate the gap. Two hundred and sixteen black men participated in this longitudinal study. Results indicated PCa testing intention was a positive but moderate predictor of three PSA testing outcomes, p<.05. Men who tested in accordance with their PCa testing intention (positive or negative) ranged from 52% to 58%. Men who intended to test but did not, were the group most responsible for the PCa intention-PSA testing gap. History of PCa testing had an independent main effect on medical claim of a PSA test between time one interview and one year after time one interview, p<.05. A significant knowledge of PCa testing controversy by PCa testing intention interaction effect on medical claim of a PSA test between time one and time two interview was found, p<.05. Men who do not know about the testing controversy are more likely to have a positive intention and fulfill their testing intention. Conversely, men who are aware and appreciate the controversy surrounding testing are more ambivalent about testing. Social cognitive variables were associated with PCa testing intention-PSA testing outcomes. These variables should be considered when designing interventions to help black men to manage their risk for PCa in a manner that is consistent with their testing preferences.