Perceived barriers to prostate cancer screenings among middle-aged men in north-eastern Germany.

OBJECTIVES

Prostate cancer ranks high in mortality. Only 18% of men entitled for screenings take advantage of this. Social-cognitive models of health psychology describe and predict health behavior. This study investigates what barriers men perceive that impede the utilization of cancer screenings.

DESIGN AND SAMPLE

Semistructured interviews were conducted in 2 general practices and 3 hospital wards. One hundred and seventy-eight men over 45 years were addressed; 64 utilized cancer screenings regularly, 3 had a diagnosis of prostate cancer, and 18 declined participation.

MEASURES

Content analyses were conducted with 83 interviews. The interview tapped into the following domains: barriers, risk perception, outcome expectancies, self-efficacy, and intentions.

RESULTS

57 men regarded their health as very important, while 47 had never utilized cancer screenings. Barriers were divided into emotional/cognitive versus organizational/structural. Sixty-four men did not utilize cancer screenings because of lack of symptoms, 22 feared a positive result, 20 had more pertinent health issues, and 18 assumed that their physicians would screen for cancer "automatically."

CONCLUSIONS

Mainly emotional/cognitive barriers were seen as important for nonutilization, especially the absence of symptoms. Following the reasoning of social-cognitive models, a first step to enhance utilization rates would be to enhance risk perception.