Community-Based Prostate Cancer Screening for High-Risk Minority and Immigrant Populations: Prostate Cancer Incidence and Implications for Public Health Screenings

Background: Most literature evidence suggests that the increased incidence of prostate cancer is due in large part to detection. Generally, prostate cancer is asymptomatic until it has spread and it is only by chance during a prostate screening, that a potentially curable prostate cancer can be detected. The fact that varying organizations have different recommendations regarding prostate cancer screening is not surprising giving the discrepant information about screening outcomes and potential benefit. We integrated a community-based prostate cancer screening into a safety-net clinic for uninsured minorities and immigrants to establish the potential benefits of screening, early detection among high-risk men and determine the incidence of prostate cancer.

Methods: Low-income and uninsured men participating in community public health programs were referred for men's wellness screenings at the safety-net clinic. Medical staff provided prostate screening information and informed consent. DRE and PSA testing were conducted for 551 men who agreed to participate in the screening. Case management and patient navigation was offered for men with abnormal results who needed further diagnostic tests.

Results/Conclusions: 25.5% of the men had abnormal PSA and 13.7% had abnormal DRE tests. Prostate cancer incidence was 9.9%. The incidence of BPH was 3.8%. Among the ethnic groups, African Americans had the highest prostate cancer incidence (12.6%) followed by non-Hispanic Whites (11.1%). Asian American men had the highest rates of abnormal PSA (27.6%) and DRE (19.5%). Incidence of prostate cancer is high when conducting target screening for high-risk and minority populations.