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Encouragement from Friends and Doctors Leads to More Participation In A Prostate Cancer Education and Screening Program

Veda N. Giri, MD

SAN FRANCISCO—Researchers studying community outreach efforts found that a friend or doctor's referral carries significant weight when it comes to getting men to participate in a prostate cancer risk assessment program. That is the finding of an analysis of recruitment strategies, which included radio ads, newsletters, participation in community fairs, and free screenings. The research covers a decade of outreach activities for Fox Chase Cancer Center's Prostate Cancer Risk Assessment Program (PRAP).

"We found that radio ads were very effective in prompting men to call our prostate cancer program, but the ones who kept their appointments after the call were those who had a friend or doctor encourage them to come in," said Veda N. Giri, MD, director of PRAP. She presented her findings today at the 2008 Genitourinary Cancers Symposium in San Francisco.

Men between ages 35 and 69 years are eligible for the program if they have a family history of prostate cancer (at least one first-degree relative or at least two second-degree relatives on the same side of the family); or are African American, regardless of family history; or have a known mutation in a gene associated with both breast and prostate cancers (BRCA1 or BRCA2). The program offers education, aggressive screening, and risk reduction strategies for men at high-risk for prostate cancer.

Of the 918 men who signed up for the program, only 640 actually came to their first appointment between 1996 and 2006, the time period of the analysis.

"That means almost 300 men didn't show up for their appointment. We need to understand what barriers are causing this disconnect," said Giri.

Giri said 60 percent of the men in the program are African-American and accrual of this population has increased over the past five years.

"We deliberately air radio ads on stations with an African-American audience," Giri said. "The ads encourage direct response through a toll-free telephone number and they worked, but we have a 50 percent drop off between those who call and those who kept the first appointment. Those who had a friend or doctor refer them, were more likely to come.

"We hope that by reaching out to physicians and community leaders, such as ministers, we can increase the participation of the men in these programs."

PRAP services include education, risk assessment, screening and an opportunity to participate in innovative prostate cancer research. Screening entails a physical exam-a digital rectal exam, or DRE-and a blood test for prostate-specific antigen (PSA).

Since the inception of the PRAP program in 1996, a variety of recruitment methods have been tried. Email reminders have been used intermittently since 2005, and analysis of this pilot project is underway to determine if show rates are improved.

In addition to having a referral, men who were older, married, employed full-time and have a college education were most likely to be recruited. White men were more likely than black men to keep the initial appointment.

Fox Chase Cancer Center, part of the Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence four consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach.  For more information, call 1-888-FOX CHASE or (1-888-369-2427).

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