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Garraway IP, Carlsson SV, Nyame YA, Vassy JL, Chilov M, Fleming M, Frencher SK, George DJ, Kibel AS, King SA, Kittles R, Mahal BA, Pettaway CA, Rebbeck T, Rose B, Vince R, Winn RA, Yamoah K, Oh WK. Prostate Cancer Foundation Screening Guidelines for Black Men in the United States. NEJM EVIDENCE 2024; 3:EVIDoa2300289. [PMID: 38815168 DOI: 10.1056/evidoa2300289] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
BACKGROUND In the United States, Black men are at highest risk for being diagnosed with and dying from prostate cancer. Given this disparity, we examined relevant data to establish clinical prostate-specific antigen (PSA) screening guidelines for Black men in the United States. METHODS A comprehensive literature search identified 1848 unique publications for screening. Of those screened, 287 studies were selected for full-text review, and 264 were considered relevant and form the basis for these guidelines. The numbers were reported according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS Three randomized controlled trials provided Level 1 evidence that regular PSA screening of men 50 to 74 years of age of average risk reduced metastasis and prostate cancer death at 16 to 22 years of follow-up. The best available evidence specifically for Black men comes from observational and modeling studies that consider age to obtain a baseline PSA, frequency of testing, and age when screening should end. Cohort studies suggest that discussions about baseline PSA testing between Black men and their clinicians should begin in the early 40s, and data from modeling studies indicate prostate cancer develops 3 to 9 years earlier in Black men compared with non-Black men. Lowering the age for baseline PSA testing to 40 to 45 years of age from 50 to 55 years of age, followed by regular screening until 70 years of age (informed by PSA values and health factors), could reduce prostate cancer mortality in Black men (approximately 30% relative risk reduction) without substantially increasing overdiagnosis. CONCLUSIONS These guidelines recommend that Black men should obtain information about PSA screening for prostate cancer. Among Black men who elect screening, baseline PSA testing should occur between ages 40 and 45. Depending on PSA value and health status, annual screening should be strongly considered. (Supported by the Prostate Cancer Foundation.).
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Affiliation(s)
- Isla P Garraway
- Department of Urology, David Geffen School of Medicine, University of California and Department of Surgical and Perioperative Care, VA Greater Los Angeles Healthcare System, Los Angeles
| | - Sigrid V Carlsson
- Departments of Surgery and Epidemiology and Biostatistics, Urology Service, Memorial Sloan Kettering Cancer Center, New York
- Department of Urology, Sahlgrenska Academy at Gothenburg University, Gothenburg, and Department of Translational Medicine, Division of Urological Cancers, Medical Faculty, Lund University, Lund, Sweden
| | - Yaw A Nyame
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle
- Department of Urology, University of Washington, Seattle
| | - Jason L Vassy
- Center for Healthcare Organization and Implementation Research (CHOIR), Veterans Health Administration, Bedford and Boston
- Harvard Medical School and Brigham and Women's Hospital, Boston
| | - Marina Chilov
- Medical Library, Memorial Sloan Kettering Cancer Center, New York
| | - Mark Fleming
- Virginia Oncology Associates, US Oncology Network, Norfolk, VA
| | - Stanley K Frencher
- Martin Luther King Jr. Community Hospital and University of California, Los Angeles
| | - Daniel J George
- Duke Cancer Institute Center for Prostate and Urologic Cancers, Duke University, Durham, NC
| | - Adam S Kibel
- Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - Sherita A King
- Section of Urology, Medical College of Georgia at Augusta University and Charlie Norwood Veterans Affairs Medical Center, Augusta, GA
| | - Rick Kittles
- Morehouse School of Medicine, Community Health and Preventive Medicine, Atlanta
| | - Brandon A Mahal
- Sylvester Comprehensive Cancer Center, Miami
- Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami
| | - Curtis A Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston
| | - Timothy Rebbeck
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston
- Harvard T.H. Chan School of Public Health, Boston
| | - Brent Rose
- Department of Radiation Oncology, University of California, San Diego
- Veterans Affairs San Diego Healthcare System, San Diego, CA
| | - Randy Vince
- Department of Urology, University of Michigan, Ann Arbor
| | - Robert A Winn
- Massey Cancer Center, Virginia Commonwealth University, Richmond
- Department of Internal Medicine, Virginia Commonwealth University, Richmond
| | - Kosj Yamoah
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
- James A. Haley Veterans' Hospital, Tampa, FL
| | - William K Oh
- Prostate Cancer Foundation, Santa Monica, CA
- Division of Hematology and Medical Oncology, Tisch Cancer Institute at Mount Sinai, New York
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Cho D, Gor B, Hwang H, Wang X, Hernandez M, Jones LA, Frost J, Roberson P, Pettaway CA. A Community-Based Prostate Cancer Screening and Education Program for Asian American Men in Medically Underserved Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:415. [PMID: 38673327 PMCID: PMC11050265 DOI: 10.3390/ijerph21040415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/12/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
This study analyzed data from a community-based prostate cancer (PCa) education and screening program (Prostate Outreach Project; POP) to enhance PCa-related knowledge among medically underserved Asian American men. It also examined PCa screening history, clinical abnormalities based on prostate-specific antigen (PSA) tests and digital rectal examination (DRE) results, and follow-up and PCa diagnosis rates. Participants-521 Asian men (251 Vietnamese, 142 Chinese, and 128 South Asians)-were offered PCa screening using PSA tests and/or DRE and an educational session on PCa. Of these men, 277 completed PCa-related knowledge surveys before and after viewing an educational video. Significant between-group differences in PCa-related knowledge were found at pre-assessment (p < 0.001) but not at post-assessment (p = 0.11), at which time all groups showed improved PCa-related knowledge. Most participants (77.9%) had never received PCa screening, but Vietnamese men had the lowest previous screening rate (17.3%). Chinese men had elevated PSA values and the highest abnormal DRE rates. Of the 125 men with abnormal screening outcomes, only 15.2% had adequate follow-up. Of the 144 men diagnosed with PCa in POP, 11.1% were Asians (seven Chinese, six Vietnamese, and three South Asian). Despite the ethnic heterogeneity among Asian men, a community outreach program may successfully enhance their PCa-related knowledge.
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Affiliation(s)
- Dalnim Cho
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (D.C.); (B.G.)
| | - Beverly Gor
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (D.C.); (B.G.)
| | - Hyunsoo Hwang
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Xuemei Wang
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mike Hernandez
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Lovell A. Jones
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (D.C.); (B.G.)
| | - Jacqueline Frost
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Pamela Roberson
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Curtis A. Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Moghul M, Cazzaniga W, Croft F, Kinsella N, Cahill D, James ND. Mobile Health Solutions for Prostate Cancer Diagnostics-A Systematic Review. Clin Pract 2023; 13:863-872. [PMID: 37623259 PMCID: PMC10453449 DOI: 10.3390/clinpract13040078] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 08/26/2023] Open
Abstract
Prostate cancer, the most common cause of cancer in men in the UK and one of the most common around the world to date, has no consensus on screening. Multiple large-scale trials from around the world have produced conflicting outcomes in cancer-specific and overall mortality. A main part of the issue is the PSA test, which has a high degree of variability, making it challenging to set PSA thresholds, as well as limited specificity. Prostate cancer has a predisposition in men from black backgrounds, and outcomes are worse in men of lower socioeconomic groups. Mobile targeted case finding, focusing on high-risk groups, may be a solution to help those that most need it. The aim of this systematic review was to review the evidence for mobile testing for prostate cancer. A review of all mobile screening studies for prostate cancer was performed in accordance with the Cochrane guidelines and the PRISMA statement. Of the 629 unique studies screened, 6 were found to be eligible for the review. The studies dated from 1973 to 2017 and came from four different continents, with around 30,275 men being screened for prostate cancer. Detection rates varied from 0.6% in the earliest study to 8.2% in the latest study. The challenge of early diagnosis of potentially lethal prostate cancer remains an issue for developed and low- and middle-income countries alike. Although further studies are needed, mobile screening of a targeted population with streamlined investigation and referral pathways combined with raising awareness in those communities may help make the case for screening for prostate cancer.
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Affiliation(s)
- Masood Moghul
- Department of Urology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London SW3 6JB, UK
| | - Walter Cazzaniga
- Department of Urology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
| | - Fionnuala Croft
- Department of Urology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
| | - Netty Kinsella
- Department of Urology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
| | - Declan Cahill
- Department of Urology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
| | - Nicholas David James
- Department of Urology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London SW3 6JB, UK
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Lillard JW, Moses KA, Mahal BA, George DJ. Racial disparities in Black men with prostate cancer: A literature review. Cancer 2022; 128:3787-3795. [PMID: 36066378 PMCID: PMC9826514 DOI: 10.1002/cncr.34433] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 01/11/2023]
Abstract
Black men are disproportionately affected by prostate cancer (PCa), with earlier presentation, more aggressive disease, and higher mortality rates versus White men. Furthermore, Black men have less access to PCa treatment and experience longer delays between diagnosis and treatment. In this review, the authors discuss the factors contributing to racial disparities and present solutions to improve access to care and increase clinical trial participation among Black men with PCa. Racial disparities observed among Black men with PCa are multifaceted, evolving from institutional racism. Cultural factors include generalized mistrust of the health care system, poor physician-patient communication, lack of information on PCa and treatment options, fear of PCa diagnosis, and perceived societal stigma of the disease. In the United States, geographic trends in racial disparities have been observed. Economic factors, e.g., cost of care, recovery time, and cancer debt, play an important role in racial disparities observed in PCa treatment and outcomes. Racial diversity is often lacking in genomic and precision medicine studies. Black men are largely underrepresented in key phase 3 PCa trials and may be less willing to enroll in clinical trials due to lack of awareness, lack of diversity in clinical trial research teams, and bias of health care providers to recommend clinical research. The authors propose solutions to address these factors that include educating clinicians and institutions on the barriers Black men experience, increasing the diversity of health care providers and clinical research teams, and empowering Black men to be involved in their treatment, which are keys to creating equity for Black men with PCa. LAY SUMMARY: Prostate cancer negatively affects Black men more than men of other races. The history of segregation and mistreatment in the health care system may contribute to mistrust among Black men. Outcomes are worse for Black men because they are less likely to be screened or to receive treatment for prostate cancer. Black men also are unlikely to participate in clinical research, making it difficult for investigators to understand how Black men are affected by prostate cancer. Suggestions for addressing these differences include teaching physicians and nurses about the issues Black men experience getting treatment and improving how Black men get information on prostate cancer.
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Affiliation(s)
- James W. Lillard
- Department of MicrobiologyBiochemistry, and Immunology, Morehouse School of MedicineAtlantaGeorgiaUSA
| | - Kelvin A. Moses
- Department of UrologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Brandon A. Mahal
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Daniel J. George
- Duke Cancer InstituteUniversity School of MedicineDurhamNorth CarolinaUSA
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5
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Carthon B, Sibold HC, Blee S, D. Pentz R. Prostate Cancer: Community Education and Disparities in Diagnosis and Treatment. Oncologist 2021; 26:537-548. [PMID: 33683758 PMCID: PMC8265358 DOI: 10.1002/onco.13749] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/19/2021] [Indexed: 12/14/2022] Open
Abstract
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 exist among Black men in this country. The 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 through 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, subanalyses 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 regardless of race. 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. 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 prostate-specific antigen, and other adverse factors, but outcomes can be attenuated in trials or in equal-access care environments. Recent data have 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.
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Affiliation(s)
| | | | - Shannon Blee
- Winship Cancer Institute, Emory UniversityAtlantaGeorgiaUSA
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Coughlin SS, Vernon M, Klaassen Z, Tingen MS, Cortes JE. Knowledge of prostate cancer among African American men: A systematic review. Prostate 2021; 81:202-213. [PMID: 33368465 DOI: 10.1002/pros.24097] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/15/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Recent studies indicate that many African American men may not be making informed decisions about prostate cancer early detection. This is partly due to patients having limited knowledge about early detection of the disease. METHODS The present review is based upon bibliographic searches in PubMed and CINAHL and relevant search terms. Articles (n = 235) published in English from 1993 through July 31, 2020 were identified using the following MESH search terms and Boolean algebra commands: prostate cancer and knowledge and African Americans. RESULTS Forty-two articles were eligible for inclusion. The results of this literature review indicate that many African American men have inadequate knowledge of prostate cancer and prostate cancer early detection. Studies indicate that knowledge of prostate cancer is particularly low among older, less-educated, lower-income, and unmarried men, along with those who lack a regular physician or health insurance. Many African American men are unaware that they are at increased risk of prostate cancer because of their age or race. CONCLUSIONS Culturally appropriate educational efforts are needed to inform African- American men about the pros and cons of prostate cancer early detection and about risk factors for the disease so that they can make an informed decision about whether prostate cancer early detection is right for them. Of particular concern is the prostate cancer knowledge of low-income and less-educated men, along with those who lack health care insurance or a regular provider.
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Affiliation(s)
- Steven S Coughlin
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
- Institute of Public and Preventive Health, Augusta University, Augusta, Georgia, USA
| | - Marlo Vernon
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
| | - Zachary Klaassen
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
- Department of Urology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Martha S Tingen
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
| | - Jorge E Cortes
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
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7
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Drake BF, Lewis-Thames MW, Brown A, Rancilio D, Hicks V. An Evaluation of Follow-Up Activities of Participants From an Urban Prostate Cancer Screening Event. Am J Mens Health 2019; 13:1557988319844353. [PMID: 30982387 PMCID: PMC6463237 DOI: 10.1177/1557988319844353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study aims to evaluate follow-up activities completed by participants attending community prostate cancer (PCa) screening events. On-site surveys were collected from participants of 17 free PCa screening events from 2007 to 2011 in the St. Louis, MO metropolitan area. Follow-up action surveys were mailed to all on-site participants to assess medical (i.e., made an appointment with a doctor, got additional testing for PCa, made an appointment to be screened) and nonmedical activities (i.e., sought social support, health information-seeking, health behavior modifications) completed after the PCa screening event. Further, t tests and chi-square tests characterized participant information from the on-site survey and within each follow-up activity category for the mailed surveys. Among 1,088 on-site community PCa screening participants, the mean age was 50 years old, 94% were Black, and 30% responded to the mailed follow-up action survey. For the recorded follow-up activities, 65% of participants reported medically reported activities, of which “made an appointment to get a yearly physical” was the most common action (29%). Health behavior modifications were the most common nonmedically related activities (44%). Health information-seeking behaviors were the least reported follow-up action (22%). Men with higher incomes, married, with health insurance, and a primary care physician, most often participated in post-PSA screening activities, namely medically-related and social support activities. Understanding the most common activities completed by participants of a community PCa screening suggests the effectiveness of community events to re-engage underserved populations in the health-care system and provides insight on acceptable health promotion opportunities.
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Affiliation(s)
- Bettina F Drake
- 1 Department of Surgery, Washington University in St. Louis School of Medicine, Division of Public Health Sciences, St. Louis, MO, USA
| | - Marquita W Lewis-Thames
- 1 Department of Surgery, Washington University in St. Louis School of Medicine, Division of Public Health Sciences, St. Louis, MO, USA
| | | | - Danielle Rancilio
- 1 Department of Surgery, Washington University in St. Louis School of Medicine, Division of Public Health Sciences, St. Louis, MO, USA
| | - Veronica Hicks
- 1 Department of Surgery, Washington University in St. Louis School of Medicine, Division of Public Health Sciences, St. Louis, MO, USA
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Irizarry-Ramírez M, Kittles RA, Wang X, Salgado-Montilla J, Nogueras-González GM, Sánchez-Ortiz R, Guerrios L, Rivera K, Shah E, Prokhorova I, Roberson P, Troncoso P, Pettaway CA. Genetic ancestry and prostate cancer susceptibility SNPs in Puerto Rican and African American men. Prostate 2017; 77:1118-1127. [PMID: 28543179 PMCID: PMC5495141 DOI: 10.1002/pros.23368] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 04/28/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND The Puerto Rican (PR) population is a racially admixed population that has a high prostate cancer (PCa) mortality rate. We hypothesized in this pilot study that West African Ancestry (WAA) was associated with PCa in this heterogeneous (PR) population. METHODS A case/case and case/control study was performed. Controls, 207 African American (AA) and 133 PR were defined as men with no PCa, a serum PSA < 2.5 ng/mL and a negative rectal examination. Cases were patients with pathological specimens from radical prostatectomies (RP) (291 PR and 200 AA). DNA was extracted from whole blood of controls and from paraffin embedded normal seminal vesicle from the RPs. We assessed the association of PCa and aggressiveness with genetic ancestry using an ancestry informative marker panel (AIMs) and Wilcoxon rank-sum test and the association of PCa and aggressiveness with 15 previously PCa associated SNPs using Chi square test. Gleason Score (GS) and tumor stage (TS) were used to define low risk (GS ≤ 7[3 + 4]), TS ≤ pT2) and high risk (GS≥ 7[4 + 3], TS > pT2) PCa. Statistical analyses were done using SAS. RESULTS No difference in overall percent WAA was found between PR cases and controls. Among PR or AA cases WAA was not associated with disease severity based upon risk group, Gleason score or stage. Among AA controls WAA was significantly higher than in cases. The SNP rs7824364 (chromosome 8q24) PCa risk allele was significantly increased among cases versus controls for both AA (P < 0.0001) and PR (P = 0.0001) men. PR men with ≥1 risk allele exhibited a higher percent of WAA (39% vs 29%, P = 0.034). CONCLUSION The SNP rs7824364, a local marker of WAA in the 8q24 region was associated with PCa among both AA and PR men and with increased WAA among PR men. This novel relationship of PCA risk loci, WAA with PCa and its phenotype among PR men deserves further study.
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Affiliation(s)
- Margarita Irizarry-Ramírez
- Department of Graduate Studies, Clinical Laboratory Sciences, School of Health Professions, University of Puerto Rico, Medical Sciences Campus, San Juan Puerto Rico, Box 365067, SanJuan, Puerto Rico 00936, 787-758-2525 ext 7035
| | - Rick A. Kittles
- Department of Surgery, School of Medicine, University of Arizona, ;
| | - Xuemei Wang
- Department of Biostatistics University of Texas, M.D. Anderson Cancer Center, ;
| | - Jeannette Salgado-Montilla
- University of Puerto Rico/MD Anderson Cancer Center Partnership for Excellence in Cancer Research, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico,
| | | | | | | | - Keila Rivera
- Department of Pathology, School of Medicine, University of Puerto Rico, Medical Sciences Campus,
| | - Ebony Shah
- Department of Surgery, School of Medicine, University of Arizona, ;
| | - Ina Prokhorova
- Department of Pathology, University of Texas M.D. Anderson Cancer Center, ,
| | - Pamela Roberson
- Department of Urology, The University of Texas M.D. Anderson Cancer Center, ,
| | - Patricia Troncoso
- Department of Pathology, University of Texas M.D. Anderson Cancer Center, ,
| | - Curtis A. Pettaway
- Department of Urology, The University of Texas M.D. Anderson Cancer Center, ,
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Gökce MI, Wang X, Frost J, Roberson P, Volk RJ, Brooks D, Canfield SE, Pettaway CA. Informed decision making before prostate-specific antigen screening: Initial results using the American Cancer Society (ACS) Decision Aid (DA) among medically underserved men. Cancer 2016; 123:583-591. [PMID: 27727462 DOI: 10.1002/cncr.30367] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/22/2016] [Accepted: 09/06/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND The American Cancer Society (ACS) recommends men have the opportunity to make an informed decision about screening for prostate cancer (PCa). The ACS developed a unique decision aid (ACS-DA) for this purpose. However, to date, studies evaluating the efficacy of the ACS-DA are lacking. The authors evaluated the ACS-DA among a cohort of medically underserved men (MUM). METHODS A multiethnic cohort of MUM (n = 285) was prospectively included between June 2010 and December 2014. The ACS-DA was presented in a group format. Levels of knowledge on PCa were evaluated before and after the presentation. Participants' decisional conflict and thoughts about the presentation also were evaluated. Logistic regression analyses were performed to determine factors associated with having an adequate level of knowledge. RESULTS Before receiving the ACS-DA, 33.1% of participants had adequate knowledge on PCa, and this increased to 77% after the DA (P < .0001). On multivariate analysis, higher education level (odds ratio, 11.19; P = .001) and history of another cancer (odds ratio, 7.45; P = .03) were associated with having adequate knowledge after receiving the DA. Levels of decisional conflict were low and were correlated with levels of knowledge after receiving the DA. The majority of men also rated the presentation as favorable and would recommend the ACS-DA to others. CONCLUSIONS Use of the ACS-DA was feasible among MUM and led to increased PCa knowledge. This also correlated with low levels of decisional conflict. The ACS-DA presented to groups of men may serve as a feasible tool for informed decision making in a MUM population. Cancer 2017;123:583-591. © 2016 American Cancer Society.
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Affiliation(s)
- Mehmet I Gökce
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Xuemei Wang
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jacqueline Frost
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Pamela Roberson
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Robert J Volk
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Durado Brooks
- Cancer Control Interventions, American Cancer Society, Atlanta, Georgia
| | - Steven E Canfield
- Division of Urology, University of Texas Medical School at Houston, Houston, Texas
| | - Curtis A Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Luque JS, Ross L, Gwede CK. Prostate Cancer Education in African American Barbershops: Baseline Client Survey Results and Differences in Decisional Conflict and Stage of Decision Making. Am J Mens Health 2016; 10:533-536. [PMID: 26860126 DOI: 10.1177/1557988316630952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
There have been very few studies to rigorously evaluate the potential of African American barbers to educate men about prostate cancer in the barbershop setting. This research brief presents baseline data from a cross-sectional survey identifying differences in decisional conflict and stage of decision making by screening status from an efficacy trial to educate African American men about informed decision making for prostate cancer screening. Those men who had already received the prostate-specific antigen (PSA) test were more advanced in their stage of decision making and had less decisional conflict about the PSA test than those men who had never received a PSA test. Educational interventions to increase informed decision making with prostate cancer screening must consider previous PSA test history as a mediating variable affecting decision self-efficacy.
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Affiliation(s)
- John S Luque
- Medical University of South Carolina, Charleston, SC, USA
| | - Levi Ross
- Georgia Southern University, Statesboro, GA, USA
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