PHILADELPHIA, April 26, 2018 /PRNewswire/ -- To catch
prostate cancer at earlier stages, when it's more easily treated,
many institutions do community outreach and education sessions to
explain why cancer screenings can be life-saving. In order to have
the highest impact, however, institutions must select where to
focus their efforts. Prostate cancer is most common among African
American men and can be more aggressive in African American and men
in a low socioeconomic bracket. Therefore, many institutions base
their outreach on these two demographic factors. However, work
researchers at Jefferson (Philadelphia
University + Thomas Jefferson
University) recently published in the journal Preventive
Medicine shows that this may not be the best approach and
offers another method for identifying areas with the highest
prostate cancer burden.
"We know that not every man in a high risk demographic will
develop prostate cancer," said senior author Charnita Zeigler-Johnson, PhD, MPH, researcher
with the Sidney Kimmel Cancer Center (SKCC) at Jefferson Health,
one of only 69 NCI-Designated Centers and only one of eight to have
a prostate cancer program of excellence. "We've seen that often the
same programs and organizations are targeted for education and
outreach efforts. We realized that we're probably leaving out large
areas of the city that potentially have higher risk. I wanted to
create a more effective tool to find those areas."
To do that, Dr. Zeigler-Johnson's team including SKCC Consortium
partners crunched data from the Pennsylvania Cancer Registry that
covered a span of nine years (from 2005 to 2014) and looked
specifically at prostate cancer cases in the city of Philadelphia. Using that data as a starting
point the researchers then created a prostate cancer composite
score that would help identify census tracts with the highest
burden of prostate cancer. The score was based on three factors: 1)
a standardized incidence ratio (SIR), which measures how much more
likely a population is to get cancer compared to national rates 2)
mortality ratio, which similarly determines the rate of death from
prostate cancer compared to national rates and 3) how advanced the
prostate cancer was at diagnosis.
"None of these factors alone can be used to categorize burden of
the disease. We found they were more predictive when combined,"
said Dr. Zeigler-Johnson, who is also Assistant Professor of
Medical Oncology at Jefferson (Philadelphia
University + Thomas Jefferson
University).
The researchers then used mapping software to geographically
identify census tracts with the highest scores. "We were surprised
to find clusters of high burden that did not always overlap with
the areas with the largest concentrations of African Americans or
those with lowest socioeconomic status measures," said first author
Russell McIntire, PhD, MPH, an
Assistant Professor in the Jefferson
College of Population Health.
"We are seeing the highest prostate cancer burden cluster in
tight geographic areas," said Dr. Zeigler-Johnson, whose earlier
work suggested similar trends. "We think it's worth studying why
these areas of the city are at higher risk for poor prostate cancer
outcomes. Could it be that neighborhoods share similar practices
and norms, or lack of awareness about prostate cancer risk? At this
point it's too early to tell."
Although the tool was developed for prostate cancer, the method
could be developed and applied to other cancer types in order to
hone educational outreach efforts for the greater impact.
Now that Dr. Zeigler-Johnson and colleagues have identified
areas of high prostate cancer risk in Philadelphia, they will develop, implement,
and test an educational outreach program. "Testing our assumptions
in the community will help us determine if this tool can be more
effective than outreach targeted using traditional methods," said
Dr. Zeigler-Johnson.
This research was supported by U.S. Department of Defense Grant
#DODW81XWH-15-1-0693, and pilot funding from the Sidney Kimmel
Cancer Center at Jefferson Health. The funders had no role in the
study design, conduct of the experiments, and interpretation of the
data.
Article reference: Russell K.
McIntire, Scott W. Keith,
Maxwell Boamah, Amy E. Leader, Karen
Glanz, Ann C. Klassen,
Charnita M. Zeigler-Johnson, "A
Prostate Cancer Composite Score to Identify High Burden
Neighborhoods," Preventive Medicine, DOI:
10.1016/j.ypmed.2018.04.003, 2018.
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SOURCE Thomas Jefferson
University