The purpose of this study was to identify attitudes toward prostate cancer, screening practices and deterrents to early detection and treatment among Black and White men 40 years and older residing in San Bernardino and Riverside, California. Data was collected using a structured questionnaire developed and pre-tested among similar participants in the study. Two hundred and fourteen men participated in the study, of which 75% were Black and 25% White. The majority (53%) was between the ages of 40-50 years, and 74% were married. The study found that there was very little difference in socioeconomic status between Whites and Blacks. Most (34%) had a college degree, but more Whites (92%) had a personal family physician than Blacks (77%), and slightly more Whites (62%) than Blacks (57%) said that prostate screening was done regularly. Findings from this study should aid in the design and development of culturally appropriate programs that will detect prostate cancer in this population at an earlier stage when treatment is more successful.

Prostate cancer is an important concern for all men since it poses a health threat especially to men over the age of 40. However, there is a higher prevalence of this disease among Black men compared to men from other racial or ethnic groups in the United States. Actually, According to the American Cancer Society facts and figures (2002), American Blacks are seen as having the highest incidence rates of prostate cancer in the world. In general, Blacks are more likely to have prostate cancer detected at a later stage and the incidence as well as mortality rates of prostate cancer among Blacks are disproportionately higher than White males. Blacks are more prone to die from the disease when compared with Whites (Merrill, & Lyon, 2000). In addition to late detection, socioeconomic status is an important factor in the morbidity and mortality rates of prostate cancer (Boring, et. al. 1992; Bal, 1992). There is still a lack of knowledge regarding prostate cancer screening as well as symptoms and treatment modalities more so for Black men than for Whites (Nash & Hall, 2002).

Although prostate cancer incidence and mortality increased during the 1980s and 1990s, this was followed by a decrease that was promising. However, the rates continued to increase for Blacks during that same period (Sarma & Schottenfeld, 2002). During the period 1991-1998, the use of PSA tests among older adults (65 years and above) on Medicare were sampled to detect whether there was an increase or decrease in prostate cancer trends. The results showed that Black men in this age group were tested less often than Whites (Etzioni, et. al., 2002). It is not fully known how acceptable the PSA test is to Black men or whether this is even the best screening method for this population. Furthermore, an investigation of health beliefs and practices of Black men about prostate cancer screening showed that knowledge of prostate cancer was fairly high. They were also aware of early detection benefits and were regularly being screened. However, they did not believe that prostate cancer was preventable, but that it was important to have good health habits. Their faith was also important to them in staying healthy and they believed that treatment for prostate cancer would interfere with sexual function (Fearing, et. al. 2000).