CAPSTONE POSTER

Unveiling the Divide: Prostate Cancer Disparities and Bridging Barriers to Care in Black Ameicans

Daniel Akaji B.S., MPH, PA-S Daytheon Sturges, PhD, MPAS, PA-C, DFAAPA, CHES

Methods

Clinical Trial Representation

The Issue

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A search was performed on PubMed, hosted by NCBI on the topic of prostate cancer and racial disparities. The search was conducted August 16, 2022- December 4, 2022. The terms “prostate cancer,” “prostate cancer and disparities,” “prostate cancer and Black men,” “prostate cancer and minorities,” and “prostate cancer and African Americans.” The search was set for studies published between 2006-2022. No language restriction was set. This resulted in 206,453 articles. The studies were reviewed and studies that were not a randomized control trial and were not specifically covering African American men were excluded.

• Prostate cancer ranks second in disease related deaths among men.• Individuals of color perpetually experience higher occurrence rates, more aggressive types of the diseases, and higher mortality rates in contrast with their white counterparts. • Black men are twice as likely then white men to die of prostate cancer. • In localized prostate carcinoma (PCa), many studies have discovered that Black patients receive radical prostatectomy (RP) less often than white patients. • Lack of effective channels, sources, and cultural approaches for communicating prostate cancer prevention information to Black men. • Studies indicate that many Black American men may be making uninformed decisions about prostate cancer early detection. This is partially due to patients having limited knowledge about early detection of the disease. Many clinicians may lack resources to engage patients in shared decision making for prostate cancer screening.

Contributing Factors

• Access to care o Black men tend to get less active treatment and less surgical treatments than other men.o Bias in the community due to lack of trust in the healthcare system o Lack of access to health centers of excellence. o Not having health insurance or not being able to reach a particular community to ensure they’re getting cancer screenings. • Low enrollment in clinical trials o Black men are usually not well represented in clinical trials. o Recruitment is low, so the results of a prostate cancer clinical trial don’t necessarily apply to Black men if they weren’t represented in the clinical trial. • Genetics o Studies have shown that prostate cancer in Black men has a different genetic profile. o Black men tend to have a more aggressive cancer and at diagnosis, they present with a higher stage of cancer.

Conclusion and Implication

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Identifying effective channels, sources, and cultural approaches for communicating prostate cancer prevention information to Black men is necessary to help equip Black men with the education necessary to make informed and proactive decisions to undergo prostate screening. While conducting this systematic review it become apparently clear that a major part of the disparities when it comes to treating prostatic cancer in Black men is the underrepresentation in clinical research. Though Black men are disproportionately negatively affected by treatment outcomes they still have not made it into the focus point of research. This issue is among the first steps that need to be taken to cause a noticeable impact in the treatment outcomes of Black men. PAs and other healthcare providers can play a role by identifying and providing Black men at risk with educational research that will be affective for their demographic. Researchers can help improve the disparity in treatment for Black populations groups by shifting focus from white research candidates to majority Black population group so they can understand the subtle complexity that cause such a major disparity in the outcome of care for the Black population.