Forecasting changes in preference over the life span: a qualitative study of African–American men’s prostate cancer decision making

Goals of work The goal of this study was to explore the processes by which African–American men, at greatest risk, might forecast and manage health changes as they age if they were diagnosed with prostate cancer. Patients and methods Twenty-nine African–American men, 40–70 years old, with no history of prostate cancer, participated in four focus groups and four follow-up individual interviews. Transcripts were analyzed using Grounded Theory, with thematic analysis and constant comparison of data. Main results There was a curvilinear relationship between age and participants’ preference for quality versus quantity of life in deciding to treat prostate cancer. Two mechanisms accounted for this: a change with age in the (1) reference point for judging value and (2) decision-making goal. Conclusions With increasing long-term survivorship, it is vital to understand the multiple decisions cancer patients will face as they continue to age. The current study is an initial step in studying how patients might anticipate and manage such changes.