Introduction and aims Prostate cancer (PC) is common and affects black African and Caribbean men disproportionally. Awareness of PC is low in these groups, but knowledge is lacking about other factors that may deter information seeking or getting tested for PC. The aim of the review was to appraise and synthesise research on knowledge and perceptions of PC among black men.

Methods Four medical and social science databases were systematically searched and reference lists of relevant papers hand searched. Non-English publications were excluded. Qualitative findings were synthesised using comparative thematic analysis, to which quantitative findings were incorporated.

Results 13 qualitative studies and 20 cross-sectional surveys were included. All except one were conducted in North-America. The analysis identified individual, cultural and social factors likely to impact on black men's awareness of, and willingness to be tested for, PC. Black men's awareness of personal risk of PC varied greatly between studies. Misunderstandings regarding methods of diagnosis and treatment were widespread. PC testing and treatment were perceived as threatening to men's sense of masculinity. Mistrust of the healthcare system, limited access to healthcare and lack of consistent, trusting relationships with health professionals were also prominent.

Conclusion These factors could contribute to late PC diagnosis and should be taken into account when planning PC services and communicating with black men who seek prostate care. Further, the review demonstrated a need for high quality studies in Europe to determine the relevance of the review findings for black European men.