New initiative aims to increase prostate cancer screening in African Americans men

African American men in Cuyahoga County have a 60% increased risk of being diagnosed with prostate cancer and an 80% increased risk of dying from prostate cancer compared to white men, according to data from the Case Comprehensive Cancer Center.

With a new $2.75 million, three-year grant from the Bristol Myers Squibb Foundation, researchers at the Case Comprehensive Cancer Center at Case Western Reserve University will collaborate with a team of community partners in a different approach to fight this health disparity.

The Cleveland African American Prostate Cancer Project, directed by Erika Trapl, an associate professor in the department of Population and Quantitative Health Sciences at the Case Western Reserve School of Medicine, will develop and implement a comprehensive, sustainable, community-based program to increase the number of African Americans screened for prostate cancer.

Trapl, the research project's principal investigator, director of the Office of Community Outreach and Engagement at the Case Comprehensive Cancer Center and director of the Prevention Research Center for Healthy Neighborhoods, said prostate cancer does not have any known modifiable risk factors, so early screening is the only way to reduce prostate cancer mortality.

"The best bet," she said, "is to identify prostate cancer early and reduce late-stage diagnosis."

To do so, Trapl has established a team of researchers that includes expertise in cancer disparities, social work, bioethics, culturally-specific intervention development, urology, genetic epidemiology, community outreach and dissemination and implementation science.

The collaboration includes the Case Comprehensive Cancer Center Community Advisory Board, the Urban Barber Association, Cleveland Department of Public Health, Office of Minority Health, The Gathering Place, University Hospitals Seidman Cancer Center, Cleveland Clinic Taussig Cancer, MetroHealth Cancer Center and the Cleveland Institute for Computational Biology. The team hopes to engage other partners as the work grows.

The project is designed to develop and evaluate a community-based prostate cancer screening program, increase the number of African American men who receive baseline prostate-specific antigen (PSA), establish awareness of prostate cancer risk and reduce cancer disparities.

Elevated or continuously rising levels of PSA--proteins produced by the prostate gland--could be a sign of prostate cancer. Studies to define the normal range of PSA levels are based on mostly white populations. By establishing a baseline for African American men at an earlier age, researchers can establish baseline PSA ranges to help detect cancer at an earlier stage.

The initiative has four objectives:

• Create a culturally and linguistically appropriate approach to prostate cancer screening education and testing in partnership with barbers, community navigators and health care providers.
• Develop and implement a Community Navigation program that provides supportive services and returns screening results, ensuring that the needs of participants and their families are met.
• Implement prostate cancer education and screening in barbershops with African American men (ages 40 and older).
• Convene regional grassroots and institutional partners to raise awareness of prostate cancer disparities and screening.

From our experience addressing health disparities and helping to eliminate barriers to equitable access to quality healthcare around the world, we recognize that this program has the elements needed for success. Through the innovative approach that recognizes the value of barbershops as community hubs, strong, deep collaborations facilitated by patient navigators and a comprehensive and strategic plan for implementation and evaluation, we are confident this program will deliver positive impact in the fight against prostate cancer for African American men."

Catharine Grimes, Program Director, Bristol Myers Squibb Foundation

Focusing on communities most at risk of suffering the impacts of serious diseases in the regions of the world that are hardest hit, the Bristol Myers Squibb Foundation empowers partners to build innovative solutions to advance health equity and improve access to quality healthcare for patients. Its programs are addressing cancer, cardiovascular disease, and immunologic disease, as well as clinical trial diversity in the United States, and prevalent cancers in Africa, Brazil and China.

The idea for the project was born in a Case Comprehensive Cancer Center Community Advisory Board meeting last year. Budding research questions are presented to the group to ensure community needs are considered from the beginning of a project through execution. Complicated science was distilled to simplified images and metaphors, making it easier to understand.

Waverly Willis, a member of the Community Advisory Board, acknowledges a history of distrust between minority people and others coming into their neighborhoods and communities. "You have to be tactful and meet people where they are," said Willis. Barbershops make up part of the fabric of the neighborhood and are a trusted environment, said Willis, owner of Urban Kutz barbershop, executive director of the Urban Barber Association and chairman of the Ohio Barber and Beauty Alliance.

"Our board pushed us to bring the work to locations central to men's lives, such as barbershops," Trapl said. "From there, the idea has taken off, thanks to the partnership of people living in this community facing these genuine issues. We hope it will become a national model."