Helping Men Find Their Way: Improving Prostate Cancer Clinic Attendance via Patient Navigation

Dobbs, Ryan W.; Stinson, James; Vasavada, Shaleen; Caldwell, Brandon; Freeman, Vincent L.; Garvey, Daniel F; Lu, Jack J.; Moreira, Daniel M.; Abern, Michael R.

doi:10.1007/s10900-019-00776-w

Cited by 5 publications

(2 citation statements)

References 29 publications

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“…45 Health care entities may also help by providing more broadly based support with navigators and other support mechanisms for clinical choices and presenting trial opportunities for patients. [46][47][48] Race and Ethnicity ). The racial disparity also seems to extend to the use of molecular imaging.…”

Section: Practical Applicationsmentioning

confidence: 99%

Evolution of Disparities in Prostate Cancer Treatment: Is This a New Normal?

Cackowski

Mahal

Heath

et al. 2021

American Society of Clinical Oncology Educational Book

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Despite notable screening, diagnostic, and therapeutic advances, disparities in prostate cancer incidence and outcomes remain prevalent. Although commonly discussed in the context of men of African descent, disparities also exist based on socioeconomic level, education level, and geographic location. The factors in these disparities span systemic access issues affecting availability of care, provider awareness, and personal patient views and mistrust. In this review, we will discuss common themes that patients have noted as impediments to care. We will review how equitable access to care has helped improve outcomes among many different groups of patients, including those with local disease and those with metastatic castration-resistant prostate cancer. Even with more advanced presentation, challenges with recommended screening, and lower rates of genomic testing and trial inclusion, Black populations have benefited greatly from various modalities of therapy, achieving comparable and at times superior outcomes with certain types of immunotherapy, chemotherapy, androgen receptor–based inhibitors, and radiopharmaceuticals in advanced disease. We will also briefly discuss access to genomic testing and differences in patterns of gene expression among Black patients and other groups that are traditionally underrepresented in trials and genomic cohort studies. We propose several strategies on behalf of providers and institutions to help promote more equitable care access environments and continued decreases in prostate cancer disparities across many subgroups.

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Section: Practical Applicationsmentioning

confidence: 99%

Evolution of Disparities in Prostate Cancer Treatment: Is This a New Normal?

Cackowski

Mahal

Heath

et al. 2021

American Society of Clinical Oncology Educational Book

View full text Add to dashboard Cite

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“…Patient navigation has also been shown to increase prostate cancer screening rates and informed decision‐making among Black men from an underserved community [45]. It has also been shown to lead to fewer missed appointments for men who were recently diagnosed with or suspected of having prostate cancer and to decreased time to diagnostic resolution of abnormal screening results [44, 46]. Given the benefit of patient navigation in breast cancer and other diseases, we hypothesize that this tool would greatly benefit our patients with prostate cancer.…”

Section: Disparities In Prostate Cancer Diagnosesmentioning

confidence: 99%

Prostate Cancer: Community Education and Disparities in Diagnosis and Treatment

et al. 2021

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Prostate cancer remains the leading diagnosed cancer and the second leading cause of death among American men. Despite improvements in screening modalities, diagnostics, and treatment, disparities exists among Black men in this country. This primary objective of this systematic review is to describe the reported disparities in screening, diagnostics and treatments as well as efforts to alleviate these disparities though community and educational outreach efforts. Critical review took place of retrospective, prospective, and socially descriptive data of English language publications in the PubMed database. Despite more advanced presentation, lower rates of screening and diagnostic procedures, and low rates of trial inclusion, sub-analyses have shown that various modalities of therapy are quite effective in Black populations. Moreover, patients treated on prospective clinical trials and within equal access care environments have shown similar outcomes. Additional prospective studies and enhanced participation in screening, diagnostic and genetic testing, clinical trials and community-based educational endeavors are important to ensure equitable progress in prostate cancer for all patients. The Oncologist 2021;9999:• • Implications for Practice: Notable progress has been made with therapeutic advances for prostate cancer, but racial disparities continue to exist. Differing rates in screening and utility in diagnostic procedures play a role in these disparities. Black patients often present with more advanced disease, higher PSA, and other adverse factors, but outcomes can be attenuated in trials or in equal access care environments. Recent data has shown that multiple modalities of therapy are quite effective in Black populations. Novel and bold hypotheses to increase inclusion in clinical trial, enhance decentralized trial efforts and enact successful models of patient navigation and community partnership are vital to ensure continued progress in prostate cancer disparities. BACKGROUND Despite notable progress over the years, prostate cancer remains the leading cancer among men in the United States, with 191,000 cases and 33,000 deaths anticipated in 2020 1. Advances in screening rates, genomic testing, imaging, and treatment have led to an almost 98% five-year survival among affected men 2. Black men, however, have traditionally had higher incidence and decreased rates of survival in prostate cancer for all stages. Statistically, 1 in 9 men overall and 1 in 7 Black men will be affected 3. Moreover, Black men are more likely to be diagnosed at an earlier age, have advanced disease at that time of diagnosis and have significantly elevated PSA levels compared to White men 3-6. They also have a higher risk of regional and metastatic disease at presentation 7,8. Several factors could possibly account for this higher relative incidence and poorer outcomes for Black men with prostate cancer. Patients with lower socioeconomic status and less education have been shown to have worse overall survival from prostate and other ...

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