Lessons Learned and New Opportunities: Strategies for Meaningful and Sustainable Improvements to Reduce Health Disparities in Prostate Cancer

Social Determinants of Health

Help bridge the ongoing care gaps, particularly among African American men, by learning more about these social determinants of health:

Introduction to Inequities in Prostate Cancer Care

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Prostate Cancer Assessment

Risk assessment and shared decision-making for PSA testing/DRE
Interpretation of PSA testing
Negative screening

Abnormal PSA and/or DRE
Confirmatory tests
No abnormalities
Abnormalities present
Treatment

DRE = digital rectal exam; PSA = prostate-specific antigen

Click the arrows in the algorithm to learn about:

Ongoing inequities in prostate cancer care
Issues with active surveillance
Additional factors that contribute to prostate cancer diagnosis and treatment delays

Available Prostate Cancer Pharmacotherapies

Chemotherapy

Cabazitaxel

Carboplatin

Cisplatin

Docetaxel

Etoposide

LHRH agonists

Leuprolide

Goserelin

Triptorelin

Histrelin

Leuprolide mesylate

First-generation antiandrogens

Nilutamide

Flutamide

Bicalutamide

Androgen receptor inhibitors

Apalutamide*

Darolutamide*

Enzalutamide

GnRH receptor antagonists

Degarelix

Relugolix*

Immunotherapy

Sipuleucel-T

Pembrolizumab (for MSI-H, dMMR, or TMB >10 mut/Mb cancer)

PARP inhibitors

Olaparib* (for HRRm mCRPC)

Rucaparib* (for BRCAm mCRPC)

Radioligand therapeutic

Lutetium Lu 177 vipivotide tetraxetan

CYP17 inhibitor and corticosteroid

Abiraterone + prednisone

Alpha particle-emitting radioactive therapeutic agent

Radium 223

* = Approved in last 5 years | Androgen deprivation therapy

BRCAm = BRCA mutated;

dMMR = deficient mismatch repair;

HRRm = homologous-recombination repair gene-mutated;

MSI-H = microsatellite instability-high;

mCRPC = metastatic castration-resistant prostate cancer

How can we better incorporate shared decision-making into prostate cancer management?

Personalizing Prostate Cancer Treatment

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Expanding the Workforce

Practicing
Urologists
in the United States
(2020)

Adapted from Winkfield KM et al. JCO Oncol Pract. 2021;17(5):224-226.

At each step towards
becoming an oncologist, the
percentage of Black
participants decreases

Adapted from American Urological Association,
The State of Urology Workforce and Practice in the
United States 2020 Linthicum,
Maryland, U.S.A., May 27, 2021.

Disclaimer: Terms related to race and ethnicity used in this activity are based on self-identification provided by participants in studies, population registries, or administrative databases, such as the US Census.