Background The barbershop is a promising setting where African-American men might receive information and education about prostate cancer. In this study, we assessed the feasibility of engaging rural barbershops as venues for barbers to deliver a prostate cancer education intervention to increase informed decision making for prostate cancer screening among customers. Methods Twelve barbershops were recruited from two separate micropolitan areas in Georgia as intervention and control sites. Structured interviews were conducted with 11 barbers in both sites about customer characteristics as well as their willingness to participate in the study. The interviews were audio-recorded and transcribed for analysis. In the intervention site, six barbers completed a survey and a pre-/posttest prostate cancer knowledge instrument following training classes. Results Barbers reported a wide average range of customers served per week (50 to 300). African-American men made up an average of 87% of customers. Barbers thought prostate cancer was an important discussion topic, felt they would be comfortable discussing it, and supported the participation of their barbershop in the study. For intervention group barbers, there was a statistically significant difference between the average pretest knowledge score of 72% (mean 12.2, SD = 3.2) and the posttest knowledge score of 89% (mean 15.2, SD = 1.1) (P = 0.03) on the 17-item prostate cancer knowledge instrument. Conclusion Based on the multiple interactions with the barbers, there was high receptivity to the topic and consensus about the importance of addressing prostate cancer with their customers. Rural barbershops represent feasible venues for delivering a prostate cancer education intervention.

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Background: In 1992, finasteride, a 5α-reductase inhibitor, was approved by the Food and Drug Administration (FDA) for the treatment of benign prostatic hyperplasia (BPH). Finasteride also showed early signs of lowering prostate-specific antigen (PSA) levels, indicating that it may be useful for the prevention of prostate cancer. The Prostate Cancer Prevention Trial (PCPT) was conducted from 1994 to 2003 and showed that finasteride reduced overall prostate cancer incidence; however, it also appeared to increase the incidence of high-grade disease. Consequently, in 2011 the FDA issued a black box warning based in part on the PCPT results. Little is known, however, about the effect this warning had on finasteride use among men after 2011. The purpose of this study was to assess the use of finasteride, for BPH or other reasons, among a sample of Prostate, Lung, Colorectal, Ovarian Cancer Prevention Trial (PLCO) participants. Specifically, we wanted to assess the effects of sociodemographic characteristics (e.g., age, race/ethnicity) and BPH on finasteride use and the effect of the FDA's black box warning on finasteride use after 2011. Method: This was a retrospective longitudinal study. Men's age, race/ethnicity, and BPH status were ascertained from questionnaires. Medication use was ascertained from linkage to Medicare Part D claims data from 2010 to 2014. Results: The sample contained 14,044 PLCO men with at least one year of part D claims data. The majority self-identified as non-Hispanic white (12,429; 88.5%); 236 (1.7%) were black, 753 (5.4%) were Asian, and 239 (1.7%) were Hispanic. Median (25th/75th) age in 2010 was 73 years (69/28). From 2010 to 2014, 11% (n=1,590) of these men used finasteride at any time. Overall, 63% (n=1,005) of the men who used finasteride reported a diagnosis of BPH. Finasteride use increased steadily over time from 5.5% in 2010 to 8.5% in 2014. Conclusion: Overall use of finasteride from 2010 to 2014 was low, and mainly in men with BPH. Finasteride use increased after the FDA's 2011 black box warning; the effect of the warning is unclear. Citation Format: Jarrett A. Johnson, Paul F. Pinsky. Use of finasteride in the Prostate, Lung, Colorectal and Ovarian Cancer Prevention (PLCO) Trial cohort: Effects of sociodemographic factors and a black box warning [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A071.

Background: Prostate cancer (PC) is the most frequently diagnosed cancer and a leading cause of mortality among men worldwide. There is evidence of a relationship between nativity and prostate cancer incidence; and, by 2050, one in five Americans living in the U.S. will be an immigrant. Little is known about the uptake of PSA screening for U.S.-based foreign-born men. Moreover, it is unclear if the prevalence of PSA screening changed within this population after the U.S. Preventive Services Task Force (USPSTF) 2012 recommendations against routine PSA screening. Objectives: Our objectives were to: 1) describe the factors associated with PSA screening prevalence for U.S.-based foreign-born men and 2) compare PSA screening prevalence before and after the USPSTF 2012 PSA screening recommendation for these men. Methods: Data were from the 2010 and 2015 National Health Interview Surveys and limited to men ages 40 years and older who responded to the question “Ever had a PSA test?”. Data were further limited to men who indicated that they were not born in the U.S. 50 states or the District of Columbia and were living in the U.S for five years or more. Multivariable logistic regression was used to examine determinants of PSA screening and to compare screening prevalence in 2010 and 2015. Results: The sample included 2,735 foreign-born men with the largest ethnic group being those who identify as Hispanic (46%). The final multivariable model included race/ethnicity, age, education, marital status, insurance status, survey year, and length of time living in the U.S. Asian men were less likely than non-Hispanic white men to report ever having had a PSA test (Odds Ratio (OR)=0.47, 95% Confidence Interval (CI) [0.36 – 0.61]). In addition, men who were widowed had lower odds than men who were married or living with a partner of ever having had a PSA test (OR=0.65, 95% CI [0.47 – 89]). Moreover, when compared to men who reported having a first degree relative with prostate cancer, men with unknown family history of prostate cancer had lower odds of ever having had a PSA test (OR=0.54, 95% CI [0.32 – 91]). Overall, men surveyed in 2015 were less likely to report ever having had a PSA test than those in 2010 (OR=0.76, 95% CI [0.63 – 0.92]). Conclusion: Among foreign-born men, lower odds of PSA screening prevalence was reported by men who were Asian, widowed and those with unknown family history of prostate cancer. Moreover, the USPSTF 2012 PSA recommendations against routine PSA screening appeared to lower PSA screening behaviors for these men several years later. These results can inform the development of prostate cancer interventions for this underserved group. Citation Format: Jarrett A. Johnson, Richard Moser, Gary Ellison, Damali Martin. Prostate-specific antigen (PSA) screening practices before and after the U.S. Preventive Services Task Force (USPSTF) 2012 Recommendations: A focus on foreign-born men [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C114.