Barriers and facilitators to prostate cancer healthcare in Black men in the UK: from diagnosis to survivorship

Purpose: Prostate cancer (PCa) is the most common cancer among UK men, with Black men twice as likely to develop it and 2.5 times more likely to die from it than White men. This study identifies the barriers and facilitators to PCa healthcare in UK Black men and suggests ways to improve engagement and experiences across the care pathway. Methods: We conducted semi-structured interviews with: (i) 12 UK Black men living with and beyond PCa. (ii) 15 UK Black men aged 45 or above. (iii) 15 UK multi-disciplinary healthcare professionals (HCPs). Interview transcripts were coded and analysed thematically, using the socioecological model to map barriers and facilitators. Results: Barriers include mistrust of Western medicine, experiences of racism, fear and stigma around PCa, inadequate culturally sensitive information, underrepresentation of Black HCPs and Black men in healthcare spaces, limited culturally sensitive psychological support, and masculinity constructs affecting open discussions and preferences for minimally invasive treatments. Facilitators include racially concordant HCPs, culturally sensitive care, continuity of care and support from partners, peers, and local community groups. Conclusion: Our findings underscore the need for tailored culturally sensitive information, community partnerships, and Black representation in both healthcare spaces and public health campaigns to improve healthcare engagement, foster trust and improve prostate cancer outcomes for Black men.