A community-based approach to educating black men in underserved communities about the risks and benefits of prostate cancer screening.

Abstract

99 Background: Black men have the highest incidence of prostate cancer (PCa) and are twice as likely to die of the disease than any other race/ethnic group in the United States. The recent controversy related to PCa screening may disproportionately impact black men who are already at greatest risk from the disease. This project sets out to develop culturally-competent educational and screening programs for men in high-risk populations so they can make an informed decision about PCa screening. Methods: A community-based education and screening program targeted towards black men living in an under-resourced community in Boston, MA was implemented. A mobile PCa screening van was initially employed and stationed at a local community health center (CHC) twice annually. Education about PCa screening was provided by a trained racially-concordant patient navigator (PN). Screening was available on the van by a primary care physician (PCP). In 2013, the pre-screening educational model was incorporated into the clinical practice of a single PCP practicing at the CHC. Every male patient over the age of 40 had an educational consultation about PCa screening with the PN before seeing their PCP. The patient would then discuss screening with the doctor and decide whether to proceed at that visit. Results: From 2004 to 2013, 20 van visits were conducted at the CHC. Two-hundred seven (207) men received PCa screening education; 179 (86.5%) elected to undergo screening. Of the men screened, 26 (14.5%) were referred for further testing as a result of their screening test. From January 2013 to September 2014, 121 men received PCa education; 100 men (82.6%) were screened. Ninety percent had both prostate-specific antigen testing and a digital rectal exam. Conclusions: These data suggest that formal PCa screening education prior to meeting with a physician is welcomed and may be a way to increase baseline screening in high risk populations. This provides an opportunity to develop an individualized prostate health management program based on individual risk profiles and to carefully monitor PSA fluctuations. The ultimate goal is to reduce unnecessary interventions while capturing PCa early in men at greatest risk.