lens

Joining Forces to Fight a Health Disparity

Researchers lead regional initiative to increase prostate cancer screening of African American men

Erika Trapl

Case Western Reserve researchers are leading a new initiative to address a troubling disparity: African American men in Cuyahoga County have a 60% higher risk of being diagnosed with prostate cancer and an 80% higher risk of dying from prostate cancer compared to white men.

The Cleveland African American Prostate Cancer Project will develop and implement a comprehensive, sustainable, community-based program to increase screening, education and outreach.

The Case Comprehensive Cancer Center leads the project, which began as an idea that local residents on a cancer center advisory board raised.

The project includes nine collaborating organizations, with more expected to join as it moves forward.

A $2.75 million, three-year grant from the Bristol Myers Squibb Foundation supports the effort, which stems from the recognition that early screening is the only way to reduce prostate cancer mortality.

"The best bet is to identify prostate cancer early and reduce late-stage diagnosis," said Erika Trapl, PhD (CWR '00; GRS '04, '07, epidemiology and biostatistics), an associate professor in the Department of Population and Quantitative Health Sciences at the university's School of Medicine, director of the Office of Community Outreach and Engagement at the cancer center and director of the Prevention Research Center for Healthy Neighborhoods.

Trapl leads the project and has established a team of researchers with expertise in cancer dis- parities, social work, bioethics, culturally specific intervention development, urology, genetic epidemiology, community outreach and dissemination and implementation science.

The project is designed to develop and evaluate a community-based prostate cancer screening program in partnership with barbershops, support services and health care providers; increase the number of African American men who receive baseline prostate-specific antigen (PSA) screening and genetic screening; implement an education program; and bring together grassroots and institutional partners to raise awareness 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 older, 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.

"From our experience addressing health disparities and helping to eliminate barriers to equitable access to quality health care around the world, we recognize that this program has the elements needed for success," said Catharine Grimes, program director for the Bristol Myers Squibb Foundation.

The idea for the project was born last year in a cancer center Community Advisory Board meeting. Budding research questions are presented to the group to ensure community needs are considered from the beginning of a project through execution.

Board member Waverly Willis said he’s observed a history of distrust between people of color and others coming into their neighborhoods and communities.

"You have to be tactful and meet people where they are," said Willis, owner of Urban Kutz barbershop, executive director of the Urban Barber Association and chairman of the Ohio Barber and Beauty Alliance.

He said barbershops are part of the fabric of the neighborhood and offer a trusted environment.

"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."