Evidence-based Prostate Cancer Screening Interventions for Black Men: A Systematic Review

Journal of Racial and Ethnic Health Disparities https://doi.org/10.1007/s40615-024-02085-y Evidence‑based Prostate Cancer Screening Interventions for Black Men: A Systematic Review Abigail Lopez1 · Jared T. Bailey2 · Dorothy Galloway3 · Leanne Woods‑Burnham4,5 · Susanne B. Montgomery4 · Rick Kittles6 · Dede K. Teteh‑Brooks1 Received: 5 March 2024 / Revised: 28 June 2024 / Accepted: 30 June 2024 © The Author(s) 2024 Abstract Prostate cancer is the second leading cause of death for men in the U.S. and Black men are twice as likely to die from the disease. However, prostate cancer, if diagnosed at an earlier stage, is curable. The purpose of this review is to identify prostate cancer screening clinical trials that evaluate screening decision-making processes of Black men. Methods The databases PubMed, Ovid MEDLINE, CINAHL Plus, and PsychInfo were utilized to examine peer-reviewed publications between 2017 and 2023. Data extracted included implementation plans, outcome measures, intervention details, and results of the study. The Critical Appraisal Skills Programme was used to assess the quality of the evidence presented. Results Of the 206 full-text articles assessed, three were included in this review. Educational interventions about prostate cancer knowledge with shared and informed decision-making (IDM) features, as well as counseling, treatment options, and healthcare navigation information, may increase prostate cancer screening participation among Black men. Additionally, health partner educational interventions may not improve IDM related to screening participation. The quality of the evidence presented in each article was valid and potentially impactful to the community. Discussion Black men face various social determinants of health barriers related to racism, discrimination, cost of health services, time away from work, and lack of trust in the healthcare system when making health-related decisions, including prostate cancer screening participation. A multifactorial intervention approach is required to address these inequities faced by Black men especially as prostate cancer is curable when diagnosed at an earlier stage. Keywords Prostate cancer · Racial health disparities · Cancer screening · Clinical trial participation · Black men Prostate cancer is the second leading cause of death for men in the United States (U.S.) [1]. Incidence rates for prostate * Dede K. Teteh‑Brooks 1 Department of Health Sciences, Crean College of Health and Behavioral Sciences, Chapman University, One University Drive, Orange, CA, USA 2 Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA 3 River Oak Center for Children, Sacramento, CA, USA 4 School of Behavioral Health, Loma Linda University, Loma Linda, CA, USA 5 Department of Surgery, Morehouse School of Medicine, Atlanta, GA, USA 6 Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, USA cancer have increased since 2014 despite declines noted in previous years (2007–2014) [1]. While the diagnosis of localized prostate cancer initially declined in the years following the discontinuance of blanket annual screening in 2012 at the recommendation of the U.S. Preventive Services Task Force, the diagnosis of regional and metastatic prostate cancer increased [2]. Many American men avoid seeking healthcare-related services due to various social and environmental determinants [3] including masculinity ideals and socialization [4]. In turn, a delay or avoidance in seeking healthcare related services can lead to a later-stage diagnosis, thus reducing the likelihood for treatment and ultimately survival. Screening tools can detect cancer in its early stages and often require less intensive treatment and are known to increase survival [5]. The American Cancer Society encourages men (age 50 for men at average risk, age 45 for men at high risk, and age 40 for men at even higher risk) to discuss Vol.:(0123456789) Journal of Racial and Ethnic Health Disparities their options and learn about the potential advantages of prostate cancer screening [1, 6, 7]. Generally, healthcare delivery clinical trial interventions are utilized by providers and researchers to identify novel ways to prevent a disease or condition [8]. This approach can support the understanding of factors that influence screening and research participation among various racial and ethnic population groups. However, the lack of diversity in clinical trials creates obstacles for addressing health concerns especially among communities of color [9, 10]. For instance, rates for prostate cancer differ among racial/ethnic groups with Black men having the highest incidence rates of prostate cancer in the U.S. [11]. Black men are twice as likely to die from the disease compared to White men [12]. Thus, it is important that Black men are represented in clinical trial interventions to identify effective strategies to prevent incidence of prostate cancer. Despite the urgent need for preventive screening, Black men’s mistrust in academic and research institutions rooted in structural racism, discrimination, and historical mistreatment by health professionals present significant barriers to adopting screening behavior [13–16]. Other factors such as cost of health services, time away from work, and societal norms about masculinity are notable barriers and concerns that Black men are confronted with when making healthrelated decisions such as prostate cancer screening participation [17–19]. The rates for prostate cancer continue to rise, approximately 12% of men will receive a diagnosis during their lifetime, and Black men are disproportionately impacted by the disease [1]. This disparity emphasizes the need to educate Black men about prostate cancer screening and encourage informed decision-making behaviors [20]. To address health-related decision-making factors and processes experienced by Black men, a systematic literature review was conducted to identify clinical trial behavioral interventions. The following review has been prepared in compliance with the criteria outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist [21]. excluded observational and non-interventional trials, studies conducted outside of the U.S., published prior to 2017, nonEnglish studies, dissertations, non-peer review manuscripts, meta-analyses, and other systematic reviews. Search Strategy and Selection Process The authors collaborated with a librarian to develop a search strategy criterion using the four online databases: PubMed, Ovid MEDLINE, CINAHL Plus, and PsychInfo. The librarian completed two search strategies for this review. These searches generated 770 articles (see Appendix A and Appendix B for the full search strategies). After removal of duplicates [22], 411 articles were included in the title/abstract evaluation. In the next phase, 205 (...truncated)