Prostate care and prostate cancer from the perspectives of undiagnosed men: a systematic review of qualitative research

OBJECTIVES: To summarise and evaluate evidence from men who had not been diagnosed with prostate cancer about their perspectives on prostate care and prostate cancer. DESIGN: A systematic review of qualitative research, on the perspectives of non-cancerous men regarding prostate cancer prevention and care. SETTING: A wide range of settings including primary and secondary care. PARTICIPANTS: Men from varied demographic backgrounds ranging between 40 to 80 years of age. DATA SOURCES: Three databases (Ovid MEDLINE, Informit, PsychInfo) and Google Scholar were searched for peer-reviewed papers in English reporting research using qualitative methods (in-depth or semistructured interviews and focus groups). REVIEW METHODS: Thematic analysis using inductive and deductive codes. Thematic synthesis was achieved through iterative open, axial and thematic coding. RESULTS: Eight papers (reporting seven studies conducted in Australia, UK and Germany) met inclusion criteria. Four major themes were identified: understanding prostate cancer, masculinity and prostate cancer, barriers to prostate healthcare and managing prostate health. It was reported that men often did not understand screening, prostate anatomy or their prostate cancer risk, and that concerns about masculinity could deter men from seeking health checks. There was evidence of a need to improve doctor–patient communication about case finding. CONCLUSION: Further investigation is required to identify and understand any differences in the perspectives and experiences of men who have not been diagnosed with prostate cancer in metropolitan and regional areas, especially where there may be variations in access to healthcare