Abstract A048: Community-based knowledge-to-action: Early detection of prostate cancer in Black men, shared decision-making tools, and clinical toolkits — a scoping literature review

Abstract

Black men have a 70-80% higher incidence of prostate cancer (PCa) and 120% higher rate of death from prostate cancer compared with men of other races and ethnicities in the US. This disparity in prostate cancer-related death represents the largest racial inequity of any cancer in the US. We conducted semi-structured interviews with Black men in Washington State assessing their knowledge, attitudes, and experiences around early detection of PCa. Findings revealed equity-related barriers Black men encounter in accessing prostate-specific antigen (PSA) tests, including: lack of information on the benefits and harms of PCa screening for patients and primary care providers (PCPs), perceived lack of understanding by PCPs of racial inequities in PCa outcomes, and lack of trusted relationships with PCPs to support PCa screening discussion and shared-decision making (SDM). A scoping review of scientific literature was conducted to identify existing studies reporting use, evaluation, or design of evidence-based or community-based toolkits used to increase SDM for PSA testing in Black men. The tools have the potential to be implemented in future clinical protocols or practice for encouraging PSA testing in Black men. Our search included papers indexed in PubMed, Embase, or CINAHL that evaluated the effectiveness or efficacy of SDM tools for PSA testing interventions and programs involving Black men from 2011-2022. Of 1,112 papers identified, our inclusion/exclusion criteria for the search yielded 8 studies, 4 of which were evidence-based interventions or evaluations that resulted in knowledge increase or awareness of PCa screening, and 4 of which were in community-based approaches or some form of community-engaged method. Cross-study comparisons were possible, as some focused on pre- and post-tests with emphasis on an increase in knowledge prevalence or the proportion of men who used the decision-making tools. The currently-available tools increased awareness of screening but did not increase the application or intent to engage in PSA testing or dialogue with providers. Our scoping review demonstrates a gap in knowledge and a need to create an evidence-based, community-based, patient-centered SDM intervention that will increase awareness, education, and support for PCa early detection among Black men through accessible, culturally relevant, and accurate clinical SDM that can be used in future practice or clinical trials. We have acquired funding through a cancer center support grant for further work in creating a community-engaged tool that will utilize a Community-Based Knowledge-to-Action approach in developing a collaborative, SDM toolkit for Black men and their providers to use that will give accurate, relevant information about PCa risk, PSA testing, and increased likelihood to engage in PSA testing for Black men.  

Citation Format: Dante Morehead, Jenney Lee, Ben Young, Victor Tolbert, John Masembe, Sung Min Kim, Katherine Briant, Erika Wolff, John Gore, Yaw Nyame. Community-based knowledge-to-action: Early detection of prostate cancer in Black men, shared decision-making tools, and clinical toolkits — a scoping literature review [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A048.