September is Prostate Cancer Awareness Month, a time to educate ourselves, our family and our friends about prostate cancer prevention and support those affected by this disease.
Prostate cancer is the second most common cancer in American men and second leading cause of cancer death among men in the US. In 2022, an estimated 268,490 people will be diagnosed with prostate cancer and an estimated 34,500 people will die from this disease in the US.
Sadly, prostate cancer disproportionately impacts men of color. Black men are 1.7 times more likely to be diagnosed with prostate cancer and more than two times as likely to die from the disease compared to white men. These startling statistics highlight how important it is to educate people about prostate cancer prevention and the racial and ethnic disparities that exist in prostate cancer care.
At AstraZeneca, we acknowledge that there is still significant work to be done. We are committed to identifying and investing in solutions to advance health equity as we aim to help close the gaps in health outcomes. One way we are doing this is through collaborative partnerships with non-profit organizations who are advancing health equity to help guide our efforts. Through the ACT on Health Equity: Community Solutions Challenge, we aim to support community-based programs that help improve community health and address the social determinants of health at the regional and local level. As a part of this program, we partnered with Zero (a non-profit organization focused on prostate cancer education, testing, patient support, research, and advocacy) to support its efforts in bridging the gap between racial and health disparities in prostate cancer through raising awareness of prostate cancer, strengthening early detection and education initiatives, and identifying new ways to further address these issues.
With this in mind, this Prostate Cancer Awareness Month, we connected with Reggie Tucker-Seeley, Vice President of Health Equity at Zero, to discuss health disparities in prostate cancer and current actions being taken to achieve more equitable health outcomes, as we are committed to elevate the voices of those working in the community to address these gaps. Reggie is a leading public health and cancer researcher who spearheads national efforts that tackle racial inequities in prostate cancer. Read more about his insight regarding the gaps in care among underserved communities, the importance of screening in preventative care, and more.
1. What should the community know about racial and health disparities in prostate cancer?
The racial disparities we see in prostate cancer are not new. While the COVID-19 pandemic seemed to shed a bit more light on the topic of racial/ethnic disparities in health, differences by race in health and the differences we are talking about here related to prostate cancer, specifically, have been around for a long time. Currently, we know that Black men are slightly more than 1.5 times more likely to be diagnosed with prostate cancer and are over two times more likely to die from the disease, and we know that if we drill down to specific states, these statistics are even worse in some places. Given that we know that these differences were not created in the last couple of years, the proposed solutions for addressing them are not likely to see these differences eliminated in a few years either. Potential solutions must include not only educating Black men, their families and communities about these differences, but also must include changes to the medical community/healthcare delivery system if we truly want to see these differences eliminated across the United States.
2. It’s been one year since we last chatted about the major disparities in education and treatment for prostate cancer. What do you think has changed since then?
Over the past year, we have continued to talk about disparities in prostate cancer, which is a great step toward health equity and will help ensure that everyone has a fair and just opportunity to find, prevent, treat, and survive prostate cancer. I hope continuing the conversation means that more people are aware of the racial differences in prostate cancer-related outcomes and are eager to do something about ensuring that in the next couple of years the size and scope of these differences are substantially reduced. I think there has also been an increased interest in the healthcare delivery system, helping to address the social determinants of health and patient social needs and a recognition that what happens outside of the physician’s office impacts how we navigate the healthcare delivery system.
3. Since we last spoke with you, what actions is ZERO taking to achieve more equitable health outcomes for people with prostate cancer?
As of October 2021, ZERO and Us Too were fully merged to create a patient-centric organization focused on prostate cancer education/awareness, support, and advocacy. From this merger, we created the Black Men’s Prostate Cancer Initiative which includes a virtual support group for Black men diagnosed with prostate cancer. The support group meets twice a month on Zoom and is led by two mental health practitioners. We are planning to implement in-person support groups under this initiative as well with the first one to start in the Atlanta area in September 2022. We recently recorded a podcast with the leaders of the Black Men’s Prostate Cancer Initiative support group to discuss what the men are getting from this support group and also to discuss how leading the support group is positively impacting the leaders’ mental health practices (Access the podcast here). This spillover impact was unexpected and we were excited to hear how this support group is positively impacting Black men outside our support group setting.
We also submitted multiple proposals focused on creating multi-stakeholder learning communities of patients, providers and healthcare system administrators to answer the questions: “What does an equitable cancer care delivery system look like and what tools do Black men need to expect and get equity as they are navigating healthcare/cancer care?” The long-term goal is to create multiple learning communities in various locations to learn about the facilitator/barriers to equity for Black men and to co-create solutions with the local community. We should hear about whether those proposals are funded this fall.
4. How can men be their own advocates for their health when it comes to prostate cancer? What can other family members do to help?
If we are going to tell men, especially Black men, to get screened for prostate cancer, I think it is important that we recognize that not all men have a usual source of healthcare. Approximately 25% of men in the US don’t have a personal doctor/healthcare provider, so telling them to get preventative screenings without also connecting them to a usual source of healthcare is less helpful in the long run. The first step is ensuring that all men have a usual source of healthcare with a trusted provider to help in deciding when to get screened for prostate cancer, and if necessary, to help in navigating the very confusing healthcare delivery system after screening if follow-up care or specialty care (eg, urologist, oncologist) is needed. In addition, it is important to recognize that prostate cancer may not have any symptoms, so discussing screening for prostate cancer with a trusted provider is critical.
Family members can help by talking about and normalizing preventative care and discussing when/if a family member has been diagnosed with cancer. This helps ensure that family members know their family history and then they can better assess their risks. Though most prostate cancers occur in men without a family history, we do know that having an immediate family member with prostate cancer more than doubles one’s risk of developing the disease. It is very important that family members openly and honestly discuss preventative care and cancer diagnoses within their families.
5. What have you learned since you joined ZERO last year?
While I think the education/awareness activities we engage in at ZERO and similar organizations are VERY important to address racial disparities in prostate cancer, we are not going to educate our way out of the problem of health disparities. In addition to providing patients with the knowledge they need to make decisions about screening, treatment, and survivorship, we must simultaneously change the healthcare delivery system to help ensure that prostate cancer patients encounter a trustworthy partner in their care as they navigate from the community to primary care to specialty care and then back to primary care and their respective communities. There are so many places along that trajectory where we lose Black men. What I’ve learned in my role at ZERO has convinced me that if we truly want to eliminate racial and ethnic disparities in prostate cancer, then we need to implement multi-level strategies that focus on educating patients and on changing the healthcare delivery system that make it easier for those patients to access and navigate high quality healthcare.