Community-Based Free Prostate Cancer Screening Program

Purpose

The objective of this study was to demonstrate both the feasibility and the value of a community-based program that offers free prostate cancer screening to Hispanic and black men living in a high-risk community.

Both black and Hispanic men experience the same dilemma with regard to prostate cancer. When the disease is detected among them, it has usually progressed to a later stage than it has reached when it is detected among white men. By that point, it is harder to treat. This leads to higher mortality rates for black and Hispanic men in comparison with white men.

A clear need exists for additional prostate cancer education and screening among these minority group men. Effectively executed, these activities can lower the cancer's stage at diagnosis among these men and thus enhance the likelihood for the successful treatment of still localized disease.

Previous investigations have revealed several types of barriers to screening for both cancer in general and for prostate cancer in particular. These impediments have included time constraints, limited funds, lack of facility with the English language, lower levels of education, misperceptions about cancer, and certain beliefs that pervade particular ethnic groups.

The East Harlem Partnership for Cancer Awareness ran monthly, free prostate cancer screening programs in neighborhood community health centers. Each of these monthly programs had two parts: (1) an educational presentation and (2) a screening session that included both a digital rectal examination (DRE) and a blood test for the prostate-specific antigen (PSA). One hundred fifty men participated; most were Hispanic or black.

To begin the program, a physician presented the educational portion of the event. A health educator provided immediate translation of his comments into Spanish. (: The educational segment opened with a slideshow, developed in conjunction with the American Cancer Society. This show presented facts about prostate cancer in both English and Spanish. Afterwards, a question and answer period took place.

Participants completed one brief (five-item) pretest on prostate cancer before the start of the educational presentation and another brief (five-item) posttest on the subject after.

Recommendations for Policy and Practice

• • Prostate screening programs should advertise via trusted and familiar institutions (e.g., newspapers, radio stations) within the community and should employ both English- and Spanish-language media outlets.

• • To make participation easy for local people, screening programs in high-risk communities should be free of charge and conveniently scheduled in the evening, after work.

• • It is important to have physicians participate on site. Many poor people have either no insurance or inadequate coverage. Often, they have no ongoing relationship with a physician.

• • Screening programs may be most effective when they include an educational component that helps attendees to understand and adhere to screening guidelines.

How Findings Support Recommendations

• • Approximately half of the participants identified Spanish as their primary language.

• • More than 70% of the participants reported that they had learned about the free prostate screening program via Spanish community newspapers, flyers/posters on display within the community, or by word-of-mouth.

• • Of the participants, 50% had no insurance coverage.

• • Steps taken to ease attendance for the local men (such as scheduling the event after work, offer transportation and making it free) facilitated their participation in the screening program.

• • Of participants, 90% completed PSA and DRE screening. All were contacted for follow-up.

• • Of participants, 98% indicated that they found the educational program easy to understand.

• • Of participants, 89% stated that they found the program informative. Their improved grasp of basic facts about prostate cancer emerged on the postintervention test.

• • Of participants, 91% indicated they would recommend the program to others.