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It is well-documented that Black men are more likely to develop and die from prostate cancer than their white counterparts. Furthermore, those who are diagnosed and receive treatment are more likely to face decisional regret—cited as “distress caused by consideration of an alternative treatment choice”—regarding their prostate cancer treatment options.

Because decisional regret can exacerbate symptoms and lower quality of life, this disparity raises new questions on broaching treatment conversations with Black patients with prostate cancer.

In order to compare decisional regret between Black and non-Black patients, this study recruited a cohort of patients with prostate cancer in which one Black patient was matched with one non-Black patient to have an even distribution of participants. A Prostate Cancer Beliefs Questionnaire was then provided to participants to gauge patient beliefs and experiences with treatment.

Based on the results of this questionnaire, it was found that Black racial identity, medical mistrust, and masculinity were associated with higher decisional regret. Medical mistrust and masculinity alone were predictive of higher decisional regret, as were poorer sexual function, urinary incontinence, and age. These findings suggest that biological, psychological, and social factors seem to work in tandem in determining the decisional regret that impacts Black patients.

There are two implications of this study. First, the association of Black racial identity and decisional regret is strong enough to call for targeted interventions among the Black population. Second, the Prostate Cancer Beliefs Questionnaire can be used to identify disparities in patient beliefs. These findings may inform future interventions to improve prostate cancer outcomes for Black men [1].

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[1] DeWitt-Foy, M. E., Gam, K., Modlin, C., Kim, S. P., & Abouassaly, R. (2021). Race, Decisional Regret and Prostate Cancer Beliefs: Identifying Targets to Reduce Racial Disparities in Prostate Cancer. Journal of Urology, 205(2), 426–433. https://doi.org/10.1097/ju.0000000000001385