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

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

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Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, Department of Medicine, University of California, 1001 Potrero Avenue, Building 10, 3rd Floor, UCSF Box 1364, San Francisco, CA, 94143, USA.
Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.



We examined prostate cancer patients' perceived engagement in treatment decision-making and associated factors by race/ethnicity in a multiethnic sample.


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.


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.


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.


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


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