February 14, 2024

The Importance of Community Outreach and Involvement in Black Men’s Fight Against Prostate Cancer

The Importance of Community Outreach and Involvement in Black Men’s Fight Against Prostate Cancer

Prostate cancer statistics for Black men paint a serious picture. Compared to other racial and ethnic groups, they are more likely to have prostate cancer, have more severe disease, and be diagnosed at a younger age. But these disparities are not inevitable. Recent studies have demonstrated that Black men who have healthcare access equal to their white counterparts fare just as well, if not better, than white men.

Racial and socio-economic health inequity is a monolithic public health issue, but there are small, significant steps that healthcare providers and the Black community can take to expand outreach and education about Black men and prostate cancer and provide Black men credible, relatable information sources, with the goal of increasing screening rates, early detection, treatment follow-up, and clinical trial involvement.

Black History Month is a good time to consider how healthcare providers can successfully engage Black men and how community involvement can raise awareness of available health resources and increase prostate cancer screening and education among Black men to attain improved health outcomes.

A culturally sensitive approach

There is no one-size-fits-all approach to healthcare education and screening. Effective outreach must take into consideration the culture and community of the people being engaged and tailor programs accordingly. Traditional approaches to prostate health education, which start in the doctor’s office, will be ineffective if patients do not have a mutually trusting and respectful relationship with their doctor or if the doctor’s office is a place patients distrust because they have previously experienced discrimination or institutionalized racism there.

A study specifically focused on Black men and prostate cancer observed that family and friends, especially respected older men in the community, composed the “caring, trusting, social environment” providing support for participants to make decisions about prostate cancer screening and early detection. The researchers also noted the value of “culturally attractive materials” and a cultural sensitivity that recognizes that Black men may have had negative healthcare experiences in the past.

Another study examined which communication channels and information sources for prostate cancer education were most effective among Black men. It found that “Black men prefer interpersonal communication for prostate cancer information,” and, outside of physicians, listed trusted information sources as pastors, barbers, community leaders, spouses, and prostate cancer survivors. It also emphasized that messaging should be culturally tailored and empower men to take “ownership” of their health.

A literature review of racial disparities in Black men with prostate cancer proposed minimizing these disparities and increasing communication and trust by “improving cultural diversification of the health care system and developing partnerships with community organizations.”

Black men and clinical trial enrollment

Black men’s involvement in clinical trials for prostate cancer is notably low, for reasons such as lack of access (either by not being treated at a large and/or academic medical center, where trials are more common, or not receiving an invitation to participate in a trial); distrust of medical research based on unethical past trials involving Black men; or previous experiences of discrimination and racism in healthcare settings.

A 2020 study on cancer health disparities found that fewer than 250 prostate tumors from Black men have been studied for genetic mutations. The same study stated that the genetic mutations predisposing a person to prostate cancer differ between men of European ancestry and men of African ancestry. With the scant number of African American men involved in clinical trials, researchers are missing genetic mutations that Black men could potentially be screened for.

One organization addressing this issue is the nonprofit Consortium on Disparities of Urologic Conditions (ConDUC). ConDUC has created the SCOPE registry to enroll African American men with prostate cancer and get them more involved with clinical trials for prostate cancer treatments.

Researchers suggest implementing culturally sensitive clinical trial recruitment, which takes place in the community and is led by racially diverse providers and research teams. Engaging with participants in their own community, such as at places of worship or community health fairs, and featuring speakers who are Black prostate cancer survivors, increased clinical trial enrollment.

Community approaches to improve prostate cancer outcomes

Among one group of Black men and women surveyed, the church was recommended for prostate cancer education as the location that reaches the most people in a community. Houses of worship are often locations for raising awareness of prostate cancer screening and prostate health, whether fliers are posted there, the pastor acts as a trusted source of information or endorses educational materials, a Black health educator presents there, or a short video on prostate cancer awareness is shown.

Barbershops are another place to reach Black men in the community. Men feel comfortable there, and barbers are generally trusted sources of information. One study found that barbershops were second only to churches as a recommended location for raising prostate cancer awareness.

Finally, family members are a common source of prostate cancer education for Black men, especially spouses or relatives who have had prostate cancer. As spouses and significant others often act as the conduit for prostate cancer information, it is equally important to target them in prostate cancer education outreach.

Certain healthcare approaches that engage community members directly and throughout the screening or treatment process are also effective in cancer awareness and prevention. Patient navigation is a community-based health intervention that puts the patient at the center of the healthcare delivery process, eliminating barriers to care by providing patients with a “navigator” who facilitates access to services and remains a constant throughout the sometimes fragmented care system. Informed decision-making involves going into the community to educate individuals on a healthcare condition so they have sufficient knowledge to confidently make a choice when it comes to their screening and treatment options. Finally, in an academic-community partnership, universities form a relationship with local organizations to increase community access to educational materials and health resources and foster meaningful and long-term engagement with the community.

To raise awareness of prostate cancer among Black men, educate them about the disease, promote a higher rate of screening, and encourage greater involvement in clinical trials, the healthcare establishment needs to consider approaches that are not confined to the hospital or doctor’s office, but are linked to the community. Healthcare providers and community leaders need to be open to collaboration that could result in a lower incidence of prostate cancer and fewer cases of clinically significant prostate cancer in Black men. With early detection, the prostate cancer survival rate can be 100 percent.

Further reading

“Addressing Cancer Disparities Through Community Engagement: Lessons and Best Practices” (Cureus. Aug. 2023)

“Association of Black Race With Prostate Cancer–Specific and Other-Cause Mortality” (JAMA Oncology. May 2019)

“Attitudes toward Genomic Testing and Prostate Cancer Research among black Men” (American Journal of Preventive Medicine. Nov. 2018)

“Cancer health disparities in racial/ethnic minorities in the United States” (British Journal of Cancer. Jan. 2021)

“Choosing Channels, Sources, and Content for Communicating Prostate Cancer Information to Black Men: A Systematic Review of the Literature” (American Journal of Men’s Health. Sept. 2018)

“A church-based intervention to promote informed decision-making for prostate cancer screening among African-American men” (Journal of the National Medical Association. March 2010)

“Community-Academic Partnerships to Reduce Cancer Inequities: The ChicagoCHEC Community Engagement Core” (Progress in Community Health Partnerships: Research, Education, and Action. 2019)

“Culture, Black Men, and Prostate Cancer: What is Reality?” (Cancer Control. Sept./Oct. 2004)

“Disparities at Presentation, Diagnosis, Treatment and Survival in African American Men, Affected by Prostate Cancer” (Prostate. June 2011.)

“Education and informed decision making for prostate cancer screening in a high risk African American community” (Integrative Clinical Medicine. Jan. 2019.)

“The efficacy and cost-effectiveness of patient navigation programs across the cancer continuum: A systematic review” (Cancer: An interdisciplinary Journal of the American Cancer Society. April 2019)

“Exploring Racial Differences Surrounding Prostate Cancer Screening: Beliefs and Attitudes in Community Dwelling Men Attending an Urban Men’s Health Event” (American Journal of Men’s Health. Nov. 2018)

“History and principles of patient navigation” (Cancer: An interdisciplinary Journal of the American Cancer Society. July 2011)

“It Takes Two to Talk About Prostate Cancer: A Qualitative Assessment of African American Men’s and Women’s Cancer Communication Practices and Recommendations” (American Journal of Men’s Health. July 2012)

“One in six Black men will be diagnosed with prostate cancer in their lifetime. Early detection is key to saving lives” (cnn.com. Jan. 26, 2024)

“Promoting informed prostate cancer screening decision-making for African American men in a community-based setting” (Cancer Causes & Control. Jan. 2022)

“Prostate Cancer: Community Education and Disparities in Diagnosis and Treatment” (The Oncologist. July 2021)

“Racial Differences in the Treatment and Outcomes for Prostate Cancer in Massachusetts” (Cancer. Aug. 2021)

“Racial disparities in Black men with prostate cancer: A literature review” (Cancer. Nov. 2022)

“Racial disparities in prostate cancer: A complex interplay between socioeconomic inequities and genomics” (Cancer Letters. April 2022)

“An Updated Look at Prostate Cancer Disparities” (Cedars-Sinai Newsroom. Oct. 27, 2023)