African American men, prostate cancer screening and informed decision making.

Prostate cancer is the second leading cause of cancer deaths in African American men. African Americans are at increased risk over other groups and have higher mortality. Since prostate cancer is highly variable among men, medical organizations are not in agreement whether men should be screened or the appropriate ages to screen. Many of these organizations recommend discussion with patients about the benefits and limitations of screening. Some of these groups support informed decision-making (IDM). Through IDM, the patient obtains all of the information about prostate cancer including risk, to make an informed choice regarding screening. Due to several factors including lowered engagement of African American men in the healthcare system, disparities in treatment, increased risk in developing and dying from the disease, as well as other cultural and structural constraints, IDM is examined and proposed as an appropriate tool for African American men. The use of IDM is discussed, along with several challenges and cautions. We conclude with recommendations and suggestions to the provider and patient to facilitate discussions regarding prostate cancer.