A SUCCESSFUL RECRUITMENT PROCESS OF AFRICAN-AMERICAN MEN FOR EARLY DETECTION OF PROSTATE-CANCER

Background. The Detroit Surveillance, Epidemiology, and End Results pr ogram data reports prostate cancer mortality rates that are two to thr ee times higher for African American compared with white American men between the ages of 50 and 70 years. Several investigators believe thi s is a result of advanced presentation of the disease secondary to a l ack of early detection participation. Attempts to recruit African Amer ican men into early-detection programs have been unsuccessful. A succe ssful process by which to achieve this objective is presented. Methods . The Detroit Education and Early Detection (DEED) program is a commun ity-based program involving the African American institutional church to attract African American men between the ages of 40 and 70 years. T he program consists of culturally specific education to remove attitud inal and behavioral barriers to the health care system, to explain the anatomy and function of the prostate gland, and to discuss issues and early detection diagnostic methods for prostate cancer. Beginning in February 1993, the DEED program was instituted in the African American community. An outreach coordinator solicits church participation by c ontacting church leaders personally. Specifically, the program include s a self-administered behavioral questionnaire, education program give n by African American physicians and prostate cancer survivors, and a prostate-specific antigen-driven screening diagnostic study. More than 90% of program staff participants in the program are African American . This is important to ensure trust in the program. Results. Early cli nical results: More than 1000 men participated in DEED by the end of J une 1994. The median age was 54.9 years, 8% of the men had prostate-sp ecific antigen levels greater than 4 ng/ml, and the cancer detection r ate was 2.5% for this young population. Conclusion. Education and earl y detection through local community institutions such as the church ca n attract African American men to prostate cancer screenings and help remove the barriers that have resulted in under-representation of this high-risk population in other early-detection efforts.