Presented by Duyen Le and Brian Nguyen Disproportionate effect of prostate cancer in African Americans as compared to the general population of MA Presented by Duyen Le and Brian Nguyen

What is Prostate Cancer? Develops when cells in the prostate proliferate uncontrollably Found only in males Most commonly diagnosed cancer in MA between 2007 and 2011 8 Types of prostate cancers 13 Adenocarcinomas (most common) Sarcomas Small cell carcinomas Neuroendocrine tumors Transitional cell carcinomas

Prostate Cancer: Risk Factors Age-Specific Incidence Rates for Prostate Cancer in MA, 2009-2013 4 Age Range Rate per 100,000 0-4 0.1 45-49 45.7 5-9 − 50-54 163.6 10-14 55-59 317.6 15-19 60-64 521.9 20-24 65-69 720.4 25-29 70-74 728.7 30-34 75-79 570.9 35-39 0.5 80-84 354.0 40-44 10.8 85+ 349.2 Risk Factors Age 11 Rarely diagnosed in men under 40 Incidence rises rapidly with age Median age at diagnosis: 68 Family history 7 Highly heritable Inherited risk estimated to be as high as 60% Race/ethnicity 6 Significantly higher among Black males

Prostate Cancer Health Disparity in MA Disproportionate burden among Black, non- Hispanics (NH) than other races From 2005 to 2009, highest incidence rates of all cancer types in Black, NH males: 626.3 per 100,000 3 Significantly elevated rate of prostate cancer in Black males: 244.7 per 100,000 1.7-2.3 times significantly higher death rates for Black in comparison to White males 3 46.5 for Blacks vs. 23.0 for Whites per 100,000

Prostate Cancer Statistics in MA

Prostate Cancer Statistics in MA

Factors Contributing to the Health Disparity Socioeconomic status (SES) 2,12 Health insurance coverage 2,12 Access to health care services 2,12 Physician-patient relationship and continuity of care 2,12 Nutrition and health

Low Socioeconomic Status Lower SES associated with higher risk Factors associated with SES contribute to differences in cancer incidence and mortality within racial and ethnic groups Less likely to be educated about prostate cancer

Barriers to Health Care Lack of health insurance coverage 3% of White adults aged 18-64 were uninsured, compared 7% of their Black counterparts 5 Unequal access to health care services Higher percentages of Black MA residents tended to report not having a personal health care provider than White MA residents 12

Less Continuity with Primary Care Physicians Black patients: Were less likely to seek a health care professional for further tests when they see abnormal screening results Expressed less trust in their primary care physicians 12

Nutrition and Health Exact roles remain unclear Obesity and diet Lack of access to affordable fresh and local fruits and vegetables Consuming a lot of red meat or high fat-dairy products appears slightly increases chances of developing cancer Lack of physical activity Smoking

Strategies for Closing the Gap Increase the diversity of health care professionals and train physicians to provide culturally-competent care Extend service hours for health care professionals to accommodate patients who are unable to visit due to schedule Provide additional support for patients to participate in screenings and receive treatment

Educating the Community Prostate Health Education Network 9 Mission To eliminate the African American prostate cancer disparity Includes efforts to increase support and resources that will lead to a cure for prostate cancer Initiatives PHEN Survivor Network Monthly Support Group Meetings Mosaic’s Barbershop Outreach in Worcester, MA

Conclusion Prostate cancer is treatable Highest incidence and mortality rates in MA among Black males Initiatives Educating minorities Encouraging individuals to seek screening Providing mental and social support Factors causing the health disparity Low SES Poor nutrition and health Lack of access to medical services Poor relationship with physicians

References "2012 Top Ten Cancers." United States Cancer Statistics. N.p., n.d. Web. 17 June 2016. "Cancer Health Disparities." National Cancer Institute. N.p., n.d. Web. 18 June 2016. CANCER INCIDENCE AND MORTALITY IN MASSACHUSETTS 2005 – 2009: STATEWIDE REPORT. Rep. N.p.: n.p., 2012. Cancer Incidence and Mortality in Massachusetts - Statewide Report 2005 - 2009. Massachusetts Department of Public Health, Dec. 2012. Web. 22 June 2016. CANCER INCIDENCE AND MORTALITY IN MASSACHUSETTS 2009 – 2013: STATEWIDE REPORT. Rep. N.p.: n.p., 2016. Cancer Incidence and Mortality in Massachusetts 2009-2013: Statewide Report. Massachusetts Department of Public Health, June 2016. Web. 22 June 2016. Chapter 3: Health Care Access. Rep. N.p., n.d. Web. 22 June 2016. "Genetics of Prostate Cancer (PDQ®)–Health Professional Version." National Cancer Institute. N.p., n.d. Web. 20 June 2016. Hjelmborg, Jacob B., et al. "The heritability of prostate cancer in the Nordic Twin Study of Cancer." Cancer Epidemiology Biomarkers & Prevention 23.11 (2014): 2303-2310. "Massachusetts Cancer Statistics." Health and Human Services - Mass.gov. N.p., n.d. Web. 21 June 2016. "PHEN Mission & Initiatives." Prostate Health Education Network. N.p., n.d. Web. 20 June 2016. "Poverty Rate By Race/Ethnicity." Kaiser Family Foundation. N.p., n.d. Web. 22 June 2016. "Prostate Cancer Risk in African Americans." Harvard Prostate Knowledge. N.p., 03 Nov. 2009. Web. 17 June 2016. Talcott, James A., et al. "Hidden barriers between knowledge and behavior." Cancer 109.8 (2007): 1599-1606. "What Is Prostate Cancer?" American Cancer Society. N.p., n.d. Web. 17 June 2016.