For Black men with prostate cancer, racial representation is a key factor affecting trust in web sites offering information on prostate cancer, reports a study within the March issue of The Journal of Urology^®, an Official Journal of the American Urological Association (AUA). The journal is published within the Lippincott portfolio by Wolters Kluwer. 

Our study shows that representation matters to Black patients in search of prostate cancer information online. Not only does it impact trust in the data, but a scarcity of Black representation in prostate cancer content seemed that Black men are at lower risk for prostate cancer.”

Stacy Loeb, MD, MSc, PhD (Hon), lead creator of Recent York University Langone Health

In truth, national statistics show that Black men have higher rates of prostate cancer in comparison with White or Hispanic men. “Thus lack of representation could have dangerous consequences reminiscent of discouraging screening amongst Black men,” Dr. Loeb adds. 

‘I do not see any melanin’: Representation affects trust in patient information 

The researchers conducted a series of focus groups with Black patients to evaluate aspects affecting the perceived trustworthiness of online sources of knowledge regarding prostate cancer. Most participants said they used the web to hunt information on their diagnosis and its treatment. 

Patients viewed “Black representation [as] a crucial factor affecting trust in online information,” Dr. Loeb and colleagues write. As one focus group participant commented when viewing a web site that depicted only White patients, “Yeah, I do not see any melanin…This is strictly where they might lose me.” 

Participants also noticed a scarcity of Black faces among the many professionals pictured in healthcare organizations and advocacy groups. As one patient commented, “As soon as I didn’t see an African American doctor represented in any of the studies, it will sort of turn me off.” Not seeing Black people pictured in online sites led some patients to present up on looking for information. 

Findings point to recommendations for online prostate cancer information 

Other aspects also affected patients’ trust in online information sources. All participants mentioned selecting reputable sources of content, reminiscent of leading healthcare institutions and national organizations. The AUA’s Urology Care Foundation offers expert information on prostate cancer, together with other urologic conditions. 

Participants preferred web sites with a “easy skilled appearance,” avoiding sites that appeared “amateur, disorganized, [or] overly flashy.” In addition they distrusted sources with any apparent financial conflict – particularly those selling alternative or herbal therapies. Even for major nonprofit organizations, patients were wary of web sites with fundraising or donation buttons. 

“Underrepresentation of Black adults in prostate cancer content has the potential to worsen prostate cancer health disparities,” Dr. Loeb and colleagues conclude. “Optimal online communications should include racially diverse representation, and evidence-based information in knowledgeable format from reputable sources without financial conflict.”