Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117558

James L. Kyle, MD, MDIV, Office of the Dean, School of Public Health, Loma Linda University, Nichol Hall, Loma Linda, CA 92350, (909) 558-4578, jkyle@sph.llu.edu, Susanne B. Montgomery, PhD, MPH, Dept. of Health Promotion & Education, School of Public Health, Loma Linda University, Nicol Hall Room 1511, Loma Linda, CA 92350, David R. Williams, PhD, Institute for Social Research, University of Michigan, Senior Research Scientist, PO Box 1248, Ann Arbor, MI 481-06-1248, Virginia Diane Woods, DrPH, MSN, Department of Health Promotion and Education, School of Public Health, Loma Linda University, 10970 Parkland Street Building, Loma Linda, CA 92350, Eric G. Walsh, MD MPH, Department of Ergent Care, Loma Linda University and Medical Center, Nichol Hall, Loma Linda, CA 92350, and Eric J. Bailey, PhD, MPH, Urban Public Health, Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, CA 90059.

Black American men have the highest incidence and death rate of prostate cancer in the world. There is little evidence that current prostate cancer guidelines sufficiently take into account the different and more aggressive disease presentation of this cancer in Black men. This is complicated by a lack of agreement on preventive testing by the major medical review groups. As a result, too little screening is occurring. To address this issue we recommend a comprehensive, multi-level approach aimed at physicians, the Black male, as well as a review of existing guidelines for screening by healthcare institutions. This paper discusses the processes we use to derive recommendations that would then be submitted to institutions with an encouragement to reconsider their current screening procedures. A professional/medical advisory panel reviewed the current guidelines regarding screening. This panel consists of Black physicians in preventive, family and internal medicine, urology, sociology, public health and medical anthropology. Our community panel members were Black men from civic and social clubs, and churches. First, the professional group reviewed the existing evidence with respect to its applicability for Black men, impact on healthcare cost, and societal benefit, in light of the current guidelines. In addition, a cost/benefit analysis was conducted using various age cut off scenarios for screening. Then the groups met and discussed the resulting evidence. Our paper presents the results of the gathered evidence, discussion, and recommendations. Ethical medical practices demand aggressive approaches when a sustained disease pattern with fatal outcomes is epidemic among sub-populations.

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