Abstract C178: Uptake of prostate cancer screening services in men living with HIV in Trinidad and Tobago
Authors: Edwards Jonathan , Song Gaole , Boyce Gregory , Todd Selena , Soyer Sharon , Galindo Tessa , Ashing Kimlin , Edwards Jeffrey 
Published: September 2024

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 &lt; 75yrs as men with high risk and used 3 ng/mL as the threshold; the threshold was 4 ng/mL for MLWH &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 &gt; 3 ng/mL. Additionally, among PSA results of participants aged over 75, 51.9% were &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.