Prostate Cancer Utilities Among African American Men

描述(申请人提供)：前列腺癌筛查是 有争议的。美国泌尿外科协会和美国癌症 该协会建议每年对男性进行筛查，从 对于高危人群中的男性，在50岁或更早的年龄(如45岁)， 例如非洲裔美国人--基于他们的两到三倍的增长 前列腺癌死亡率。然而，决策分析模型有 证明前列腺癌筛查的净效益取决于 男性重视治疗的常见副作用(阳萎、大小便失禁和 肠道症状)，使用效用评估进行测量。尽管关键的是 公用事业对筛查决策的重要性，关于以下方面的数据很少 对治疗副作用的偏好。候选人会把注意力集中在她 健康状况评价与效用方法的适应性研究 在强调非洲农村的研究人群中使用的衡量标准 美国男性将探索种族和年龄差异的政策含义 前列腺癌筛查指南。 这项提案的具体目标是：1)调整和试点健康状况 工具，效用评估访谈和民族和民族的访谈 关于前列腺癌的文化信仰适用于农村非裔美国人 人口2)评估公用事业和相关协变量(包括 社会人口学、文化信仰和基线前列腺特异性健康) 来自普通公众的450名男性(225人，主要是农村人) 非洲裔美国人男性，225名非非洲裔美国人男性)和125名使用 这些工具3)分析数据以调查潜在的差异 在按组划分的公用事业中(例如，非洲裔美国人与非非洲裔美国人， 年轻男性与老年男性、医生与普通大众男性) 在多变量模型中控制这些协变量。 拟议的调查将提供有关患者的新信息 直接适用于健康政策、生活质量和 成本效益分析。结果将被纳入决定中 支持工具，帮助面临是否接受筛查的男性 前列腺癌。这项提案将为候选人提供关键的新的 癌症预防、医学人类学、仪器开发、 多变量统计建模和少数民族心理。这 研究将在弗吉尼亚大学的 人类学、健康评估科学和医学；华盛顿大学 和马萨诸塞州综合医院。这些合作将促进 候选人在成果研究方面的职业生涯，并确保项目的成功。

DESCRIPTION (provided by applicant): Screening for prostate cancer is controversial. The American Urological Association and the American Cancer Society recommend that screening should be offered to men annually beginning at age 50 or at an earlier age (e.g., 45 years) for men in high-risk groups, such as African Americans - based on their two to three times increased prostate cancer mortality. However, decision analytic models have demonstrated that the net benefit of prostate cancer screening depends on how men value the common side effects of treatment (impotence, incontinence, and bowel symptoms) as measured using utility assessment. Despite the critical importance of utilities to the screening decision, few data exist regarding preferences for the side effects of treatment. The candidate will focus her research on adapting the methods of health status assessment and utility measurement for use in a research population that emphasizes rural African American men to explore the policy implications of race- and age-specific prostate cancer screening guidelines. Specific aims of this proposal are: 1) to adapt and pilot a health status instrument, utility assessment interview and an interview of ethnic and cultural beliefs regarding prostate cancer for use in a rural African American population 2) to assess utilities and relevant covariates (including sociodemographics, cultural beliefs, and baseline prostate-specific health) in a cohort of 450 men from the general public (225 largely rural African-American men, 225 non-African American men) and 125 physicians using these instruments 3) to analyze the data to investigate potential differences in utilities by group (e.g., African American versus non-African American, younger versus older men, physicians versus men in the general public) controlling for these covariates in a multivariable model. The proposed investigation will contribute new information regarding patient preferences directly applicable to health policy, quality-of-life, and cost-effectiveness analyses. Results will be incorporated into decision support tools to assist men faced with the decision whether to be screened for prostate cancer. The proposal will provide the candidate with critical new skills in cancer prevention, medical anthropology, instrument development, multivariable statistical modeling, and ethnic minority psychology. This research will be performed at the University of Virginia Departments of Anthropology, Health Evaluation Sciences, and Medicine; Washington University and Massachusetts General Hospital. These collaborations will foster the candidate's career in Outcomes Research and ensure the project's success.