Developing evidence-based afrocentric PCA screening guidelines

Loma Linda University, Loma Linda CA

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Abstract

Background:Non-Hispanic Black men have the highest incidence rate of prostate cancer in the world, tend to[unreadable] present with the disease at younger ages, often with more aggressive forms of the cancer, and have higher[unreadable] death rates. It is not clear why this unequal burden of prostate cancer persist, but higher death rates are[unreadable] associated with late detection, which is associated with lack of screening. Disagreement among professional[unreadable] medical review organizations exist whether to recommend screening, or at what age to begin. Interventions[unreadable] to improve open communication about the decision to test between a patient and their physician are advised.[unreadable] Recent empirical research suggests to target both Black men and their physicians. At the same time, health[unreadable] care systems need to be engaged in discussions about the pros and cons of prostate cancer screening for[unreadable] Black men.[unreadable] Overall Study Aim: Utilizing a social ecological framework, we propose to use existing preliminary data,[unreadable] collect additional infromation from physicians regarding consideration of Black American anthropological[unreadable] factors and aggressive disease pathology in Black men, to review current prostate cancer screening[unreadable] guidelines and make recommendtions for development of early detection and screening based on findings,[unreadable] institutional policy changes, and cultural competency training.[unreadable] Methods: Fifty physicians will participate. A panel of 8 Black physician experts in prostate cancer prevention,[unreadable] will review the literature on prostate cancer in Black men, come together (using the model of a "Think Tank")[unreadable] and present the pros and cons of prostate cancer screening guidlines based on evidence from the literature[unreadable] and case studies. Prostate cancer screening guidelines will be developed based on empirical data,[unreadable] aggressive presentation of prostate cancer in Black men, and medical anthropological findings. Finally, to[unreadable] influence policy development on this issue for the County, we will present the finding to healthcare systems[unreadable] decision-makers and the County Board of Supervisors regarding the need for prostate cancer screening[unreadable] policies, with strong encouragement to adopt the policy to screen Black men early. Imapct and outcome[unreadable] evaluations of the effectiveness of a countywide prostate cancer screening policy will be assessed related to[unreadable] changes in physician practicies, as well as incidence of new cases related to stages of pathology, mortality,[unreadable] morbidity, and quality of life among Black men related to prostate cancer.