Prostate Cancer Education, Detection, and Follow-Up in a Community-Based Multiethnic Cohort of Medically Underserved Men

Abstract

The Prostate Outreach Project (POP) provided free prostate cancer (PCa) education and early detection to medically underserved communities. POP recruited subjects in medically underserved communities. PCa education and detection events occurred in POP locations (static) or natural gathering places (mobile) within the community. PCa education was delivered by video and evaluated using a questionnaire. Screening consisted of serum prostate specific antigen (PSA) and digital rectal examination (DRE). A navigated follow-up strategy was utilized to provide medical care for subjects with abnormal screening examinations (ASE). POP recruited 4420 men, 62.8% (2667) were African American (AA). Most participants had a high school education, and no prior screening. Fifty four percent (2159) were uninsured and 41% (1811) had no access to a physician. PCa knowledge increased following the educational video. PSA levels were elevated in 9.8% (436) while 233(6.9%) had an abnormal DRE. Follow-up among 609 men with ASE was successful in 40% (244), despite a navigated approach. Overall 3.3% (144) cancers were diagnosed among the POP with AA subjects exhibiting a significantly higher incidence. Recruitment, education, and PCa testing among a medically underserved cohort was successful. However failure to follow through on ASE could contribute to maintaining the disparity in PCa outcomes noted among AAs and the medically underserved if not addressed.

Informed decision making before prostate‐specific antigen screening: Initial results using the American Cancer Society (ACS) Decision Aid (DA) among medically underserved men

“…In our cohort, 33.1% of participants had adequate baseline knowledge, and this rate increased to 77% after the presentation. Increased knowledge on PCa screening after a DA has been reported previously in several studies . The level of increase in PCa knowledge depends on many factors, such as baseline level of knowledge, educational status of the population, the type of DA (Web‐based, print, or presentation), and the content of the DA.…”

Genetic ancestry and prostate cancer susceptibility SNPs in Puerto Rican and African American men

“…This finding has prompted us to study other potential confounders since the AA controls were recruited from community settings in Houston while the cases were AA patients from the MDACC, a tertiary referral center for treatment of cancer. We have previously shown that subjects recruited in the Houston community study exhibited a lower socioeconomic (SES) status in terms of education, insurance, and having a regular physician . Freeman et al , directly correlated low SES with lower PCa survival and found that this was eliminated in equal access care settings .…”

“…We have previously shown that subjects recruited in the Houston community study exhibited a lower socioeconomic (SES) status in terms of education, insurance, and having a regular physician. 27 Freeman et al 33, directly correlated low SES with lower PCa survival and found that this was eliminated in equal access care settings. 33 evaluating other variables their group found that obesity was a significant predictor of aggressive PCa for the EA population more than the AA cohort.…”

“…The MDACC control subjects consisted of 207 self‐identified AA men who were a part of the Prostate Outreach Program (POP) early detection study performed among underserved men with a normal DRE and serum PSA < 2.5 ng/mL . The MDACC PCa cases consisted of 200 previously consented self‐identified AA men who underwent RP with available tissue blocks.…”

Prostate Cancer Education in African American Barbershops

“…A recent study demonstrated that a culturally tailored decision aid delivered in barbershops led to significantly more men intending to have a prostate-specific antigen (PSA) test after a follow-up period of three months (Frencher et al, 2015). Another study using PCa screening events in medically underserved communities in Houston, Texas reported over half of the men had no prior history of screening (Ashorobi et al, 2015). This article describes baseline survey findings from an efficacy study conducted with African-American barbershop clients in two micropolitan areas in central and southeast Georgia.…”