Prostate Cancer Screening Research Articles

Pioneering Prostate Cancer Diagnosis: Evaluating AI Against Traditional Methods - A Systematic Literature Review

ABSTRACT Prostate cancer is one of the most common forms of men's cancer in the world and the understanding of its epidemiology is crucial to effective prevention, early detection and management strategies. This systematic review highlights the potential of artificial intelligence-based diagnostic methods to revolutionize the early diagnosis of prostate cancer. A comprehensive literature search was carried out using databases such as PubMed, Google Scholar and Scopus. After removing duplicates, titles and abstracts were examined in 279 studies and the following full texts were examined in 128 studies. We have ten studies to review in total. Therefore, we chose to review data for all 10 identified studies that applied AI techniques to detect ca prostate. The Paige Prostate Alpha AI system significantly enhances pathologists' diagnostic capabilities, leading to more accurate and effective prostate cancer detection. These limitations indicate that further research is required to address these issues and validate the results in a more diverse and controlled environment. AI-based diagnostic methods have shown significant promise in enhancing the early detection of prostate cancer. As technology continues to advance, integrating AI with traditional diagnostic approaches could lead to more effective, efficient, and accurate prostate cancer screening and diagnosis. Future studies should focus on large-scale clinical trials and real-world applications to validate these findings and facilitate the adoption of AI in clinical settings. Keywords: Prostate Cancer, Artificial Intelligent, Deep Machine Learning, MRI

Assessing the causal relationship between gut microbiota and prostate cancer: A two-sample Mendelian randomization study

BackgroundNumerous studies indicate that the gut microbiome is closely associated with prostate cancer (PCa), however, owing to various confounding factors, the causal relationship between gut microbiota and PCa remains unclear. MethodsA 2-sample Mendelian randomization (MR) analysis utilized genome-wide association study (GWAS) data on the gut microbiota of 18,340 participants and GWAS summary statistics on PCa involving 46,3010 participants. Inverse variance weighted (IVW) served as the primary method, complemented by the MR-Egger method, weighted median method (WME), simple mode method (SM), and weighted mode method (WM). Finally, to confirm the robustness of the results, heterogeneity test, pleiotropy test, and leave-one-out sensitivity test were conducted. ResultsIVW analysis revealed that 12 specific gut microbial taxa were potentially causally associated with PCa; the genera Victivallis, Akkermansia, Odoribacter, Butyrivibrio, and the families Enterobacteriaceae, Verrucomicrobiaceae, as well as the orders Verrucomicrobiales, Enterobacteriales and the class Verrucomicrobiae, were found to be positively associated with PCa risk. Conversely, the genera Eubacterium ruminantium group, Candidatus Soleaferrea, and RuminococcaceaeUCG003 were negatively associated with PCa risk. ConclusionsOur MR study's results support a genetically predicted causal relationship between the gut microbiota and PCa, and we identified 12 specific gut microbial taxa. These findings could offer new targets for PCa screening and treatment.

Exploring prognostic biomarkers in pathological images of colorectal cancer patients via deep learning.

Hematoxylin and eosin (H&E) whole slide images provide valuable information for predicting prognostic outcomes in colorectal cancer (CRC) patients. However, extracting prognostic indicators from pathological images is challenging due to the subtle complexities of phenotypic information. We trained a weakly supervised deep learning model on data from 640 CRC patients in the prostate, lung, colorectal, and ovarian (PLCO) cancer screening trial dataset and validated it using data from 522 CRC patients in the cancer genome atlas (TCGA) dataset. We created the colorectal cancer risk score (CRCRS) to assess patient prognosis, visualized the pathological phenotype of the risk score using Grad-CAM, and employed multiomics data from the TCGA CRC cohort to investigate the potential biological mechanisms underlying the risk score. The overall survival analysis revealed that the CRCRS served as an independent prognostic indicator for both the PLCO cohort (p < 0.001) and the TCGA cohort (p < 0.001), with its predictive efficacy remaining unaffected by the clinical staging system. Additionally, satisfactory chemotherapeutic benefits were observed in stage II/III CRC patients with high CRCRS but not in those with low CRCRS. A pathomics nomogram constructed by integrating the CRCRS with the tumor-node-metastasis (TNM) staging system enhanced prognostic prediction accuracy compared with using the TNM staging system alone. Noteworthy features of the risk score were identified, such as immature tumor mesenchyme, disorganized gland structures, small clusters of cancer cells associated with unfavorable prognosis, and infiltrating inflammatory cells associated with favorable prognosis. The TCGA multiomics data revealed potential correlations between the CRCRS and the activation of energy production and metabolic pathways, the tumor immune microenvironment, and genetic mutations in APC, SMAD2, EEF1AKMT4, EPG5, and TANC1. In summary, our deep learning algorithm identified the CRCRS as a prognostic indicator in CRC, providing a significant approach for prognostic risk stratification and tailoring precise treatment strategies for individual patients.

How Can Guidelines Give Clearer Guidance on Prostate Cancer Screening?

How Can Guidelines Give Clearer Guidance on Prostate Cancer Screening?

Oral Microbiome and Subsequent Risk of Head and Neck Squamous Cell Cancer

The oral microbiota may be involved in development of head and neck squamous cell cancer (HNSCC), yet current evidence is largely limited to bacterial 16S amplicon sequencing or small retrospective case-control studies. To test whether oral bacterial and fungal microbiomes are associated with subsequent risk of HNSCC development. Prospective nested case-control study among participants providing oral samples in 3 epidemiological cohorts, the American Cancer Society Cancer Prevention Study II Nutrition Cohort, the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, and the Southern Community Cohort Study. Two hundred thirty-six patients who prospectively developed HNSCC were identified during a mean (SD) of 5.1 (3.6) years of follow-up. Control participants who remained HNSCC free were selected by 2:1 frequency matching on cohort, age, sex, race and ethnicity, and time since oral sample collection. Data analysis was conducted in 2023. Characterization of the oral bacterial microbiome using whole-genome shotgun sequencing and the oral fungal microbiome using internal transcribed spacer sequencing. Association of bacterial and fungal taxa with HNSCC was assessed by analysis of compositions of microbiomes with bias correction. Association with red and orange oral pathogen complexes was tested by logistic regression. A microbial risk score for HNSCC risk was calculated from risk-associated microbiota. The primary outcome was HNSCC incidence. The study included 236 HNSCC case participants with a mean (SD) age of 60.9 (9.5) years and 24.6% women during a mean of 5.1 (3.6) years of follow-up, and 485 matched control participants. Overall microbiome diversity at baseline was not related to subsequent HNSCC risk; however 13 oral bacterial species were found to be differentially associated with development of HNSCC. The species included the newly identified Prevotella salivae, Streptococcus sanguinis, and Leptotrichia species, as well as several species belonging to beta and gamma Proteobacteria. The red/orange periodontal pathogen complex was moderately associated with HNSCC risk (odds ratio, 1.06 per 1 SD; 95% CI, 1.00-1.12). A 1-SD increase in microbial risk score (created based on 22 bacteria) was associated with a 50% increase in HNSCC risk (multivariate odds ratio, 1.50; 95% CI, 1.21-1.85). No fungal taxa associated with HNSCC risk were identified. This case-control study yielded compelling evidence that oral bacteria are a risk factor for HNSCC development. The identified bacteria and bacterial complexes hold promise, along with other risk factors, to identify high-risk individuals for personalized prevention of HNSCC.

Potentially functional variants of PARK7 and DDR2 in ferroptosis-related genes predict survival of non-small cell lung cancer patients.

Ferroptosis, a form of regulated cell death, is characterized by iron-dependent lipid peroxidation. It is recognized increasingly for its pivotal role in both cancer development and the response to cancer treatments. We assessed associations between 370,027 single-nucleotide polymorphisms (SNPs) within 467 ferroptosis-related genes and survival of non-small cell lung cancer (NSCLC) patients. Data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial served as our discovery dataset, while the Harvard Lung Cancer Susceptibility Study used as our validation dataset. For SNPs that remained statistically significantly associated with overall survival (OS) in both datasets, we employed a multivariable stepwise Cox proportional hazards regression model with the PLCO dataset. Ultimately, two independent SNPs, PARK7 rs225120 C>T and DDR2 rs881127 T>C, were identified with adjusted hazard ratios of 1.32 (95% confidence interval = 1.15-1.52, p = .0001) and 1.34 (95% confidence interval = 1.09-1.64, p = .006) for OS, respectively. We aggregated these two SNPs into a genetic score reflecting the number of unfavorable genotypes (NUG) in further multivariable analysis, revealing a noteworthy association between increased NUG and diminished OS (ptrend = .001). Additionally, an expression quantitative trait loci analysis indicated that PARK7 rs225120T genotypes were significantly associated with higher PARK7 mRNA expression levels in both whole blood and normal lung tissue. Conversely, DDR2 rs881127C genotypes were significantly associated with lower DDR2 mRNA expression levels in normal lung tissue. Our findings suggest that genetic variants in the ferroptosis-related genes PARK7 and DDR2 are associated with NSCLC survival, potentially through their influence on gene expression levels.

Association between female infertility and stroke mortality: evidence from the PLCO cancer screening trial.

While infertility affects about 15% of women during their reproductive years, its long-term impact on stroke mortality after this period remains unclear. This study aims to investigate the association between infertility and stroke mortality in women using data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial. We analyzed data from 75,778 female participants aged 55-74 years with a median follow-up of 16.84 years. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for stroke mortality, adjusting for potential confounders. Among participants, 14.53% reported infertility. During follow-up, 1,159 women died from stroke. Compared to women without infertility, those with infertility had a higher risk of stroke mortality (HR 1.21, 95% CI 1.04-1.41, p = 0.016). This association remained statistically significant after adjusting for age, race, education level, marital status, smoking status, body mass index, history of hypertension, history of heart attack, history of diabetes mellitus, birth control pill use, hormone replacement therapy, endometriosis, first menstrual period and pregnancy history (HR 1.20, 95% CI 1.02-1.42, p = 0.029). Sensitivity and subgroup analyses yielded consistent results. The findings of this study indicate that infertility is associated with an increased risk of stroke mortality in women. Further research is needed to confirm these findings and elucidate the underlying mechanisms.

Abstract B083: Community-based knowledge-to-action translation to improve early detection of prostate cancer among Black individuals

Abstract Introduction: Black individuals have 70-80% higher incidence and 120% higher mortality from prostate cancer when compared to all other groups in the US. This is the largest racial disparity in cancer-related mortality in the US and has persisted over the last five decades despite improvements in the diagnosis and treatment of prostate cancer. Our previous work demonstrated that intensified screening practices could reduce prostate cancer mortality among Black individuals. Challenges impede the translation of these findings into real-world interventions and practices. The objective of this study was to design a patient-centered and culturally tailored knowledge toolkit to improve the knowledge and awareness of prostate-specific antigen (PSA) testing in Black individuals to facilitate informed shared-decision making between Black patients and primary care providers. Methods: Using a community-partnered participatory research approach, we convened a working group of Black prostate cancer survivors and community advocates, and clinicians, researchers, and health communications specialists. During monthly meetings, the working group followed Graham’s Knowledge-to-Action framework to synthesize information from: 1) peer-reviewed literature on the use of shared decision-making aids; 2) interviews conducted by our research team with Black individuals regarding barriers and facilitators to access PSA testing; and 3) community input on PSA testing and prostate cancer early detection. We then facilitated four iterative design sessions with the working group to develop recommendations for toolkit content, framing, and format. Results: With the working group, we designed a comprehensive set of resources to increase knowledge and awareness of PSA testing for early detection of prostate cancer among Black individuals. The design framework includes detailed recommendations on the content, framing, and format for resources contained in the toolkit. Recommendations encompass: 1) interactive web-based documents that cover comprehensive information about prostate cancer risk and screening; 2) printable shared decision-making documents that present evidence-based information about the use of PSA testing to guide conversations between Black individuals and their primary care providers; and 3) educational videos focused on prostate cancer fundamentals and dispelling common misconceptions about prostate cancer risk and screening, with content delivered by Black prostate cancer survivors and interviews with Black providers and prostate cancer researchers. Conclusion: This study addressed the need for a community-developed approach to increasing knowledge and awareness about prostate cancer screening and early detection in an accessible, culturally tailored, and accurate manner. We used a collaborative process that centered the experiences of Black prostate cancer survivors and advocates in the design of a toolkit that can facilitate decision-making discussions between Black individuals and their care providers for use of PSA testing for prostate cancer screening. Citation Format: Jenney R. Lee, Sung Min Kim, Yohali Burrola- Mendez, Dante' Morehead, Marty Chakoian, Michael Ware, Kojo Ward, Floyd Gossett, Vida Henderson, Patricia Egwuatu, Burcu Darst, John Masembe, Erika M. Wolff, Yaw A Nyame. Community-based knowledge-to-action translation to improve early detection of prostate cancer among Black individuals [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B083.

Abstract A134: Overcoming barriers to prostate cancer screening: A tethered educational video and mobile screening program

Abstract Background: Prostate cancer (PC) is the most commonly diagnosed cancer in men. One in 8 White and 1 in 6 Black men will be diagnosed with PC in their lifetime. The current prostate cancer screening (PCS) guidelines recommend shared decision making to discuss the advantages and disadvantages of PCS. In Philadelphia, among men over 40 years of age, only 39% and 18% have discussed the advantages and disadvantages of PCS with a provider, respectively. Among men over 50 years of age, only 47% have had a Prostate Specific Antigen (PSA) test. This research evaluated an educational video designed to increase awareness of the advantages and disadvantages of PCS and provided access to mobile PSA screening among the diverse men in Philadelphia. Methods: Between April-May 2024, we enrolled men aged 40+ at community events within and around the city of Philadelphia and excluded men who previously participated in the study. Screening events were advertised through social media, printed flyers, emails, and text messages disseminated by labor union administrators to union members. Participants completed a questionnaire which examined PC and PCS knowledge, decisional conflict, and likelihood to screen before and after viewing a 12-minute educational video on an iPad or personal device. The video consisted of a conversation between a local pastor, who is a Black PC survivor, and a urologist. The video included the pastor’s personal experience with PC and allowed him and the urologist to have the opportunity to address common PC misconceptions and myths. After the video, participants provided video feedback. A $10 gift card and giveaways were offered before presenting the option for on-site PSA draws by a licensed phlebotomist. Results: A total of 133 men (38% Black; 56% White, 10% Hispanic; mean age of 53 years old (s.d.=10.4)) completed the pre and post questionnaires. A total of 61% of participants had never had a PSA test. Twenty-two percent did not know blood testing was an option, and 28% did not know they needed a PSA test. Thirty-two percent of participants would have been somewhat or very unlikely to get screened without this program. Having the screening option come to their community or place of work was the determining factor for 81% of screened participants. After watching the video, PC knowledge improved in 6 of 10 items (overall knowledge score pre vs. post p&amp;lt;.01). Post video, decisional conflict was reduced in 9 of the 10 questionnaire items (each item had a p≤.001). A total of 95% of participants stated ‘yes’, they would undergo PCS after watching the video versus 69% being either somewhat or very likely to get screened before watching the video (p&amp;lt;0.001). All 95% were screened on-site. The video information was deemed useful to 99% and credible by 97% of respondents. Conclusion: This educational video increased PCS awareness, intention to screen for PC, and completion of PCS. When coupled with an educational video, mobile PSA screening initiatives are an effective and efficient way to increase access to PSA screening for diverse men. Citation Format: Mallorie C. Jones, William Buckley, Alexandra Cordoba, Suji Kim, David Barreto, Debanjan Pain, Vivian Nguyen, Blane Newberry, Daniel Lee, Carmen E. Guerra. Overcoming barriers to prostate cancer screening: A tethered educational video and mobile screening program [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A134.

Abstract C178: Uptake of prostate cancer screening services in men living with HIV in Trinidad and Tobago

Abstract Background: Compared to other groups, Black men have a higher incidence and mortality of prostate cancer (PCa). Worldwide, the Caribbean region has one of the highest age-standardized PCa incidences with 76 cases per 100,000 population per year. PCa incidence in predominantly Afro-Caribbean countries ranges from 160 in Barbados to 304 men diagnosed per 100,000 in Jamaica. In Tobago, 10% of adult men over 40yrs were found to be diagnosed with PCa. Additionally, men living with HIV (MLWH) are more susceptible and vulnerable to cancer due to their immune-compromised status. Thus, in the Caribbean, there is a pressing need for clinic-based PCa screening in MLWH. Objective: A preliminary quality improvement evaluation of a prostate cancer screening (PSA test) program targeting MLWH in Trinidad and Tobago from January 2019 to May 2024. Methodology: The electronic health information system from a large clinic was used to abstract prostate cancer screening (PSA) delivery. No personal identifiers were collected from the system to protect the privacy of individuals and abide by Trinidad and Tobago’s data protection law. According to NCCN guidelines, since most of our patients were Afro-Caribbean or Mixed, this study treated all MLWH aged &amp;lt; 75yrs as men with high risk and used 3 ng/mL as the threshold; the threshold was 4 ng/mL for MLWH &amp;gt;75yrs. Evaluation of quality improvement of interventions approach was applied. Descriptive analyses were conducted using SPSS. Results: Between January 2019 and May 2024, a total of 2,442 MLWH were eligible to participate in the PSA screening clinic. The average age was 54.0 (age range: 40- 90). 62.9% were Afro-Caribbean, 17.6% were Mixed, 7.4% were East Indian/Indian, and 0.6% were Caucasian. 45.6% of MLWH completed at least secondary education. 26.2% reported having steady partners and 82.5% reported their sexual orientation was heterosexual. Among all MLWH who attended the clinic, 2,127 (87.1%) were referred for PSA tests and 1,640 (77%) MLWH received their PSA tests. For PSA results collected from participants aged 40-75, 86.6% were ≤ 3 ng/mL and 13.4% were &amp;gt; 3 ng/mL. Additionally, among PSA results of participants aged over 75, 51.9% were &amp;lt; 4 ng/mL and 48.1% were ≥ 4 ng/mL. Discussion: To the best of our knowledge, this study is the first of its kind in the Caribbean region. Among MLWH, PSA screening rate was relatively high at 77%. Not too surprising, the PSA results showed 13% of men under 75 and almost 50% of men over 75 had elevated PSAs requiring confirmatory screening and follow-up. Hence, we conclude that a whole-person care approach that includes cancer prevention with prostate cancer screening can be effective. We thus recommend an implementation and dissemination science approach to create strategies for adopting, implementing, sustaining, and disseminating clinic-based prostate cancer-related prevention to reduce related morbidity and mortality among MLWH within the Caribbean and the Americas. Citation Format: Jonathan Edwards, Gaole Song, Gregory Boyce, Selena Todd, Sharon Soyer, Tessa Galindo, Kimlin Ashing, Jeffrey Edwards. Uptake of prostate cancer screening services in men living with HIV in Trinidad and Tobago [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C178.

Urologists and pathologists in prostate cancer screening

Urologists and pathologists in prostate cancer screening

Abstract B171: Using a transdisciplinary collaboration process to create a plan to address prostate cancer disparities

Abstract WI ranks highest in the US for overall cancer incidence and mortality among Black/African American (Black) individuals. Prostate cancer (PC) is the most frequently diagnosed cancer among men in WI and the second leading cause of cancer death. This region has numerous challenges including segregation, poverty, educational achievement gaps, and high Black imprisonment rates which impact PC awareness, screening, and treatment. To effectively address a problem as complex as prostate cancer disparities, multiple perspectives are needed. We brought together a transdisciplinary team that integrated community and academic expertise to develop a shared understanding of prostate cancer disparities and potential causes and to create a community action and research agenda. The team met every other week for 16 months. During that time, This team engaged in a facilitated process developed through our Community and Cancer Science Network that included: 1) Incubation: co-learning about the multi-factorial causes of PC disparities by reviewing available data, engaging experts, and seeking input from researchers, health care providers and community members; 2) Innovation: using this information to consider potential solutions to create a draft plan; and 3) Integration: seeking feedback to ensure the draft plan met the needs of diverse audiences and then refined the solutions. During the Incubation phase. the team reviewed available literature and data; developed a root causes analysis of disparities, conducted surveys, interviews and discussion sessions with researchers, healthcare providers, and community members (n=98); invited presentations by relevant experts and survivors, and engaged in robust discussions. In the Innovation phase, the team analyzed the data and reflected on opportunities to address the issues outlined in the root cause analysis. Potential solutions were assessed for fit and feasibility. Finally, in the Integration Phase, the team conducted a series of town halls with community members and researchers (n=70) to review the draft plan and seek feedback. The team used the feedback to refine the plan and consider next steps. Final recommendations include: 1) Patient navigation to assist men with PC at diagnosis; 2) A trusted messenger campaign to increase PC awareness; 3) Increase provider and community awareness of genetic risk; 4) Patient-provider forums to build relationships and trust; 5) Expand survivor support offerings for Black men with PC; 6) Improve PC screening education; 7) Increase provider awareness of current screening guidelines; 8) Expand research into the role of stress in PC. Our transdisciplinary approach is effective in engaging and blending diverse perspectives to generate solutions to complex problems. Future work will sustain this approach in implementing solutions through collaborative efforts. Citation Format: Tobi Cawthra, Kevin Izard, Robert Allen, Darryl Davidson, Chris Nielson, Ambrose Wilson-Brown, Deepak Kilari, Marquayla Ellison, Dev Karan, Ericka Sinclari, Alvin Flowers, Kyle Ashley, Leonard Wilson, Marcus Hogans, Kenneth Jacobsohn, Melinda Stolley. Using a transdisciplinary collaboration process to create a plan to address prostate cancer disparities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B171.

Abstract C179: Train the trainer series in Southern California a call to action for cancer prevention and screening

Abstract Background: Alarmed by low rates of cancer screening in disenfranchised communities and medical deserts in Southern California, City of Hope launched a cancer prevention and control training program to broadly disseminate cancer screening and healthy living educational resources to Health Educators who serve the most vulnerable within our Catchment areas. Methods: The project was IRB approved as exempt came internally from City of Hope. To increase cancer prevention and uptake of cancer screening, we focused on training of Community Health Workers (CHW) from Federally Qualified Health Centers (FQHC’s), community hospitals, faith-based organizations. This community co-designed training included Cancer 101 , on best practice for Breast, Cervical, Colorectal, Lung, and Prostate screening, and Clinical and Biospecimen Studies and SB 987. Complete and online redcap enrollment survey, along with 2 brief pre and post surveys per series topic. The presentations and surveys will be facilitated by COE staff. Trainees completed surveys via RedCap. Surveys will be conducted via Redcap. Results: TTT series trained 101 trainees on 8 topics. Trainees included: Asian (14.9%), Black/African-American (6.9%), Latino/Hispanic (73.3%), Pacific Islander (2.0%), White/European American (5, 5.0%), Mix (3.0%). The gender identities trained were Male (10.9%), Female (87.1%), Transgender: Female to Male (2.0%). Facilitators of screening included Someone to talk about worries/fears about cancer (73.0%), Someone to go with and help at the appointment (53.0%), Paid time off from work (63.0%), Clinical provider recommendation/encouragement (57.0%), Free/ Low cost exams (81.0%), Insurance to pay for exams (68.0%), Free transportation (64.0%), Child care services (53.0%), In-language educational materials (62.0%), Language Interpretation services (51.0%), Community education programs (66.0%), Gift Cards or Incentives (4.0%).The participants' education level was mostly college educated (64.0%), high school (33.0%), and less than high school (3.0%). The top 3 cancers affect our community the most are breast, colon, and lung. Conclusion: The conclusion is community partners are ready to be engaged and trained in cancer prevention and screening. Cancer centers, leveraging their COE, can respond to this call to action. Citation Format: Kimlin Ashing, Lauren D'Souza, Brenda Gascon, James Morrison, Veronica Tejada, Alexis Garden, Jose Gomez, Sophia Yeung. Train the trainer series in Southern California a call to action for cancer prevention and screening [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C179.

Abstract B041: Community-based prostate cancer screening for Black men

Abstract PURPOSE: The 5-year relative survival rate for men with prostate cancer (PC) is greater than 99% when diagnosed at an early stage. The prognosis is much worse for men diagnosed with advanced disease as there is no cure for metastatic PC. With the establishment of prostate- specific antigen (PSA) blood testing as an effective tool for early screening for PC, the prevention of morbidity and mortality from this disease proves possible. However, Black men are more likely to develop aggressive PC and die, yet less likely to be screened despite population-specific guidelines recommending shared decision-making for high-risk groups to begin at age 40. For these reasons, increasing the rate and reach of PSA screening within the community is an innovative approach to raise awareness and reduce mortality from PC for Black men. METHODS: Morehouse School of Medicine’s (MSM) Prostate Cancer Precision Prevention Program (PCP3) leverages community partnerships to provide point-of-care PSA testing at no cost to Black men in the greater Atlanta area and rural Georgia. Community-based screening events were initiated in June 2023 and have been conducted in collaboration churches, municipalities, and non-profit organizations. Participants were recruited at these events and consented to provide one tube of blood drawn by MSM phlebotomists and registered nurses for quantification of PSA levels. Results were processed through Morehouse Healthcare and participants were contacted with individual results and provided with options for follow-up. RESULTS: To date, PCP3 has conducted more than three dozen community-based screening events. Over 1000 Black men have received PSA testing with variable results. CONCLUSION: PCP3 has provided awareness and PSA testing to over 1000 Black men in Atlanta and rural Georgia at higher risk for aggressive and lethal PC. PCP3 aims to assess whether community- based screening reduces mortality from PC for Black men in Georgia over the next few years. Citation Format: Pam Cooper, Kitty Carter-Wicker, Eddie R. Stanley, Imani A. Boyd, Nicole Mavingire, Brian Rivers, K. S. Kimbro, Rick A. Kittles, Leanne Woods-Burnham. Community-based prostate cancer screening for Black men [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B041.

Abstract B084: Multi-Stakeholder Engagement to Create Equity in Prostate Cancer Outcomes through Identifying Community Priorities in Early Detection Research

Abstract Introduction: Black individuals have a two-fold higher rate of prostate cancer death in the US compared with other groups. This is the largest racial inequity in US cancer-related deaths. Annual prostate-specific antigen (PSA) testing among Black individuals starting at age 45 years could reduce mortality by 30% compared with current screening practices. Few current practice guidelines make race-conscious screening recommendations due to a lack of trial data on screening in Black populations; only 0-3% of participants in practice-informing PSA screening trial cohorts were Black. An equity-informed approach is required to ensure that trial designs reflect the priorities and perspectives of Black individuals to ensure their participation in future research. Methods: We partnered with the Black and African-descent Collaborative for Prostate Cancer ACtion (BACPAC) to conduct a survey to identify community priorities in prostate cancer early detection research. Respondents were asked to rate the importance of 15 research topics, then select the three topics most critical for research. Members of the BACPAC Virtual Research Community (VRC), a nationally representative group of 2,016 Black prostate cancer survivors and community members, were invited to participate. Eligible members were Black prostate cancer survivors and family members/caregivers of Black prostate cancer survivors. Those who met the inclusion criteria were emailed a unique link to complete the online survey. Results: 1,557 eligible VRC members received a survey link, 1,224 surveys were completed (78.6% response rate). 60% of respondents were survivors, 38% were family members/caregivers, and 2% were both. More than 80% of respondents rated each of the 15 research topics as moderately to very important. Topic rankings revealed two overarching priority areas, representing 6 out of 15 topics included in the survey. These areas were 1) the use of reflex testing in the setting of elevated PSA to aid detection of clinically significant cancer and 2) establishing optimal timing for initiation or interval of PSA testing for prostate cancer screening. Regarding use of reflex testing, 97.7% of respondents prioritized blood (44.3%), urine (27.8%), or MRI (25.6%) reflex testing. Regarding timing of PSA testing, 51.5% of respondents prioritized customized screening schedules based on personal risk factors, with 24.9% selecting to improve rates of screening and 26.6% selecting to improve detection of clinically significant cancers, and 25% of respondents prioritized initiating screening at age 45 to improve early detection of prostate cancer. Conclusion: Our survey identified critical research topics that are of high importance to Black prostate cancer survivors and their families/caregivers. Our findings bridge a critical gap in prostate cancer early detection research, from which Black individuals have been historically excluded. Involving Black prostate cancer survivors in research design may help ensure that Black individuals are better represented in future clinical trials. Citation Format: Jenney R. Lee, Sung Min Kim, Erika M. Wolff, Yohali Burrola-Mendez, Dante' Morehead, Ben Young, Raymond Miller, Robert Ginyard, Frank Fields, Marty Chakoian, Patrick Bingham, Daniel VanArsdale, Mike Crosby, Tony Minter, Thomas Farrington, John Masembe, Burcu Darst, Ruth Etzioni, Adam Murphy, Sam L Washington, Jonathan Shoag, Yaw A Nyame. Multi-Stakeholder Engagement to Create Equity in Prostate Cancer Outcomes through Identifying Community Priorities in Early Detection Research [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B084.

Abstract A031: Methylomic Biomarkers Associated with Prostate Cancer in Black Men

Abstract Introduction: The prostate cancer (PCa) disparity remains the highest cancer disparity in the US, with Black men facing an estimated 78% higher incidence and 230% higher mortality than White men. However, current understanding of risk factors for PCa such as socioeconomic status (SES), diet, and genetics cannot fully explain these disparities. Our objective is to examine DNA methylation (DNAm) markers in a cohort of Black men and assess their associations with PCa status. Methods: We randomly selected 100 Black men for DNAm profiling (50 cases diagnosed with clinically significant (Gleason Grade 3+) prostate cancer and 50 age-matched controls) from two larger cohorts. The cohorts recruited 400 Black men who were newly diagnosed with sporadic PCa as well as 400 controls matched on age and race. All men were 40-79 at recruitment and were enrolled from urology clinics at five Chicago-area medical institutions. All PCa cases underwent a transrectal prostate biopsy for abnormal prostate-specific antigen (PSA) or digital rectal exam and had a histologically confirmed prostate cancer and were not previously diagnosed with PCa. All men in the control group had been recruited from community prostate cancer screening events or were referred to participating urology clinics and had a negative prostate biopsy for a PSA &amp;lt;10ng/ml and were not diagnosed with PCa for 2 years of follow-up. Men with prior PCa diagnosis or conditions known to affect PSA levels were excluded. After enrollment and informed consent, all men provided demographic and lifestyle data via three questionnaires, followed by venipuncture for DNA collection. These specimens were obtained using buffy coat extraction after red blood cell lysis, centrifugation, and pipetting off the overlying plasma and buffy coat for freezing followed by Illumina EPIC arrays for DNAm assays. We examined DNAm markers in gene promoter regions associated with PCa using logistic regression and adjusted for multiple testing using Bonferroni correction. All models controlled for age, BMI, smoking status, first degree family history of PCa, blood cell types, and technical control variables. Results: We found 2,180 CpG sites in gene promoter regions associated with any PCa in this population. The top ten strongest associations identified in our models include loci on genes that have already been associated with prostate cancer progression (MAFG, FAM65B, OSM, PRKAG2), risk (SLC11A1, LAT), and metastasis (S1PR4) as well as immune system functioning (RAP1GAP2). Conclusions: Our initial findings suggest that DNAm markers may be useful predictors of clinically significant PCa status among Black men. Additional research is currently ongoing to expand the sample size of the DNAm profiling and to explore links between these loci and social determinants of health, as well as associations with more advanced (i.e., higher Gleason Grade) PCa. Citation Format: Brian T. Joyce, Yishu Qu, Jun Wang, Kai Zhang, Zequn Sun, Lifang Hou, Adam B. Murphy. Methylomic Biomarkers Associated with Prostate Cancer in Black Men [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A031.

Abstract A115: Utilizing digital storytelling to improve the recruitment of Black and Hispanic patients for a genetic predisposition to prostate cancer screening trial

Abstract Introduction: Clinical genomics leads to more effective cancer prevention, diagnosis, and treatment. Prostate cancer (PC) significantly impacts Black and Hispanic men, but participation in clinical trials and PC risk management methods like genetic testing and screening remains low. Barriers to diversity and inclusion in clinical trials include cultural and socioeconomic factors. Digital storytelling is an effective tool for building trust and increasing community engagement. We aim to develop and assess the use of digital storytelling to improve recruitment of Black and Hispanic patients in a trial for men at high genetic risk for developing PC (clinicaltrials.gov NCT03805919) and raise awareness of genetic testing and enrollment in clinical trials within these communities. Methods: Guided by the Assessing Community Engagement Conceptual Model, we will establish a community advisory panel (CAP) comprised of patient advocates, community, and clinical partners with a strong interest in increasing clinical trial representation of Black and Hispanic patients at high genetic risk for developing PC. CAP participants will be identified from existing partners and through snowballing techniques, which involve asking partners to recommend other CAP participants. The CAP will co-design storytelling interview questions, baseline, and outcome assessments and collectively determine effective methods for digital story dissemination. To evaluate the impact of storytelling on awareness, interest, and participation in genetic testing, medical management, and clinical trial recruitment among Black and Hispanic men, outcome assessments co-designed with the CAP will be administered pre and post-video viewing and include viewer qualitative interviews. Results: Filmed interviews with Black and Hispanic participants will be conducted. Interviews will focus on participant experiences with clinical trials, genetic testing, and cancer risk management. Interview transcripts will be in English and Spanish with forward and back translation to ensure accuracy using National Institutes of Health resources. Local and national partners, community organizations, faith-based institutions, healthcare facilities, and advocacy groups identified by the CAP will facilitate dissemination. Digital stories will be distributed across various multimedia platforms to maximize outreach and accessibility, including community web platforms, social media channels, podcasts, local radio stations, educational workshops, health fairs, cultural events, churches, and support groups. Conclusion: Building strategies for improving patient-centered care delivery and community engagement within culturally diverse populations will enhance clinical trial diversity and inclusion. Using digital storytelling as a recruitment strategy for clinical trials can foster trust, engagement, and participation within Black and Hispanic communities. Study findings will contribute to future clinical trial design and recruitment to enhance underrepresented minority participation in clinical research. Citation Format: Yi Liu, Brenda Adjei, Anna Couvillon, Kathleen Calzone, Fatima Karzai. Utilizing digital storytelling to improve the recruitment of Black and Hispanic patients for a genetic predisposition to prostate cancer screening trial [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A115.

Semen sEV tRF-Based Models Increase Non-Invasive Prediction Accuracy of Clinically Significant Prostate Cancer among Patients with Moderately Altered PSA Levels.

PSA screening has led to an over-diagnosis of prostate cancer (PCa) and unnecessary biopsies of benign conditions due to its low cancer specificity. Consequently, more accurate, preferentially non-invasive, tests are needed. We aim to evaluate the potential of semen sEV (small extracellular vesicles) tsRNAs (tRNA-derived small RNAs) as PCa indicators. Initially, following a literature review in the OncotRF database and high-throughput small RNA-sequencing studies in PCa tissue together with the sncRNA profile in semen sEVs, we selected four candidate 5'tRF tsRNAs for validation as PCa biomarkers. RT-qPCR analysis in semen sEVs from men with moderately elevated serum PSA levels successfully shows that the differential expression of the four tRFs between PCa and healthy control groups can be detected in a non-invasive manner. The combined model incorporating PSA and specific tRFs (5'-tRNA-Glu-TTC-9-1_L30 and 5'-tRNA-Val-CAC-3-1_L30) achieved high predictive accuracy in identifying samples with a Gleason score ≥ 7 and staging disease beyond IIA, supporting that the 5'tRF fingerprint in semen sEV can improve the PSA predictive value to discriminate between malignant and indolent prostate conditions. The in silico study allowed us to map target genes for the four 5'tRFs possibly involved in PCa. Our findings highlight the synergistic use of multiple biomarkers as an efficient approach to improve PCa screening and prognosis.

Adaptation of the socioecological model to address disparities in engagement of Black men in prostate cancer genetic testing

BackgroundBlack men consistently have higher rates of prostate cancer (PCA)- related mortality. Advances in PCA treatment, screening, and hereditary cancer assessment center around germline testing (GT). Of concern is the significant under-engagement of Black males in PCA GT, limiting the benefit of precision therapy and tailored cancer screening despite longstanding awareness of these disparities. To address these critical disparities, the Socioecological Model (SEM) was employed to develop comprehensive recommendations to overcome barriers and implement equitable strategies to engage Black males in PCA GT.MethodsClinical/research experts, national organization leaders, and community stakeholders spanning multiple regions in US and Africa participated in developing a framework for equity in PCA GT grounded in the SEM. A novel mixed-methods approach was employed to generate key areas to be addressed and informed statements for consensus consideration utilizing the modified Delphi model. Statements achieving strong consensus (> =75% agreement) were included in final equity frameworks addressing clinical/community engagement and research engagement.ResultsAll societal levels of the SEM (interpersonal, institutional, community, and policy/advocacy) must deliver information about PCA GT to Black males that address benefits/limitations, clinical impact, hereditary cancer implications, with acknowledgment of mistrust (mean scores [MS] 4.57-5.00). Interpersonal strategies for information delivery included engagement of family/friends/peers/Black role models to improve education/awareness and overcome mistrust (MS 4.65-5.00). Institutional strategies included diversifying clinical, research, and educational programs and integrating community liaisons into healthcare institutions (MS 4.57-5.00). Community strategies included partnerships with healthcare institutions and visibility of healthcare providers/researchers at community events (MS 4.65–4.91). Policy/advocacy included improving partnerships between advocacy and healthcare/community organizations while protecting patient benefits (MS 4.57-5.00). Media strategies were endorsed for the first time at every level (MS 4.56-5.00).ConclusionThe SEM-based equity frameworks proposed provide the first multidisciplinary strategies dedicated to increase engagement of Black males in PCA GT, which are critical to reduce disparities in PCA-mortality through informing tailored screening, targeted therapy, and cascade testing in families.

Advances in Photoacoustic Endoscopic Imaging Technology for Prostate Cancer Detection

The rapid progress in biomedical imaging technology has generated considerable interest in new non-invasive photoacoustic endoscopy imaging techniques. This emerging technology offers significant benefits, including high spectral specificity, strong tissue penetration, and real-time multidimensional high-resolution imaging capabilities, which enhance clinical diagnosis and treatment of prostate cancer. This paper delivers a thorough review of current prostate cancer screening techniques, the core principles of photoacoustic endoscopy imaging, and the latest research on its use in detecting prostate cancer. Additionally, the limitations of this technology in prostate cancer detection are discussed, and future development trends are anticipated.