Abstract A049: Community partnership to empower Black men to drive research to identify barriers to prostate cancer early detection and equitable care
Authors: Lee Jenney R. , Morehead Dante' , Young Ben , Tolbert Victor , Masambe John , Britt Garrett , Neuenschwander Lars , Schuppe Kyle , Pelman Richard , Johnson Debi , Kim Sung Min , Wolff Erika M. , Gore John L. , Nyame Yaw A. 
Published: December 2023

Abstract
Introduction: Black men have a two-fold higher rate of prostate cancer death in the US compared with other men, the largest racial inequity in US cancer-related deaths. Annual PSA testing among Black men starting at age 45 years would reduce mortality compared with current screening practices. However, the US Preventive Service Task Force (USPSTF) guidelines do not make screening recommendations specifically for Black men. Black men comprised only 0-3% of practice-informing PSA screening trial cohorts. Given the burden of prostate cancer among Black men, capacity must be built to empower Black men and their communities to develop and execute clinical trials that may provide guidance on early detection strategies. Methods: We conducted semi-structured interviews to examine prostate cancer screening access among Black men in the Pacific Northwest, and we surveyed primary care physicians (PCPs) and urologists in the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region to assess knowledge, attitudes, and practices about prostate cancer screening. Interviews were recorded and transcribed; consensus coding and thematic analysis were used to identify structural barriers associated with screening access. Anonymous online surveys were distributed to physicians via email using REDCap. Results: 29 men participated in semi-structured interviews. We identified three equity-related barriers related to prostate cancer screening access: (1) lack of information on the benefits and harms of prostate cancer screening, (2) lack of PCP knowledge about prostate cancer disparities confronted by Black men, and (3) lack of trusted relationships with PCPs to support shared decision-making about prostate cancer screening. 32 urologists and 31 PCPs completed the survey. Nearly all urologists and PCPs were aware of the 2018 USPSTF guidelines regarding PSA testing (93.8% and 96.7%, respectively). 75% of urologists and 6.5% of PCPs agreed that PSA testing can significantly reduce prostate cancer mortality. Conclusion: Findings from the survey support the perception reported by interviewees that there is variation in knowledge and support for prostate cancer screening for early detection of prostate cancer among Black men. Our combined findings further demonstrate that (1) Black men have unique needs around early detection of prostate cancer and (2) patient partnerships can identify these areas of need and best inform patient-centered design of practice-changing research studies. Future Directions: With funding from the Patient Centered Outcomes Research Institute we will apply these findings by (1) building engagement and research capacity among a cohort of Black men with a history of prostate cancer and their advocates, (2) identifying community derived research priorities around the early detection of prostate cancer in Black men, and (3) developing a research agenda to inform future large, patient-centered, comparative effectiveness clinical trials in early detection of prostate cancer in Black men.
Citation Format: Jenney R. Lee, Dante' Morehead, Ben Young, Victor Tolbert, John Masambe, Garrett Britt, Lars Neuenschwander, Kyle Schuppe, Richard Pelman, Debi Johnson, Sung Min Kim, Erika M. Wolff, John L. Gore, Yaw A. Nyame. Community partnership to empower Black men to drive research to identify barriers to prostate cancer early detection and equitable care [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 A049.