Drivers Influencing Prostate Cancer Treatment Decision making - A Qualitative Analysis of Underrepresented Men across...

To investigate decision drivers of prostate cancer treatment modalities by analyzing qualitative interviews among a cohort of underserved prostate cancer survivors.

The Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study is a prospective cohort study comparing treatment strategies for localized prostate cancer (n = 3691). Participants of the study were selected from 5 SEER registries: Atlanta, Los Angeles, Louisiana, New Jersey, and Utah. A subset of CEASAR participants were contacted for qualitative interviews (n = 66). Semi-structured phone interviews were then conducted between November 2020 and August 2021 by a trained qualitative researcher under the direction of senior investigators. This study re-examines qualitative data particularly among the underserved participants to explore additional themes that may not have been previously emphasized.

Overall 27% (n = 18) of CEASAR patients who completed the qualitative interview were considered underserved: low SES background and/or racially and ethnically minoritized. Three themes of importance emerged from underserved men: financial toxicity 22% (n = 4/18), role as a primary caregiver 11% (n = 2/18), and medical mistrust 17% (n = 3/18), serving as alternative decision drivers that may have influenced underserved men's treatment choices and long-term reflections on those decisions.

As one of the most longitudinal and diverse population-based observational studies to date on prostate cancer, the CEASAR study offers a unique perspective into the different aspects of care that may impact underserved prostate cancer survivors. This subgroup analysis of CEASAR provides insight into factors influencing decision making among underserved prostate cancer survivors.