Purpose:The Prostate Health Index is validated for prostate cancer detection but has not been wel... more Purpose:The Prostate Health Index is validated for prostate cancer detection but has not been well validated for Gleason grade group 2-5 prostate cancer detection in Black men. We hypothesize that the Prostate Health Index has greater accuracy than prostate specific antigen for detection of Gleason grade group 2-5 prostate cancer. We estimated probability of overall and Gleason grade group 2-5 prostate cancer across previously established Prostate Health Index ranges and identified Prostate Health Index cutoffs that maximize specificity for Gleason grade group 2-5 prostate cancer with sensitivity >90%.Materials and Methods:We recruited a “cancer-free” Black control cohort (135 patients) and a cohort of biopsy naïve Black men (158) biopsied for elevated prostate specific antigen. Descriptive statistics compared the prostate cancer cases and controls and the frequency of Gleason grade group 2-5 prostate cancer across Prostate Health Index scores. Receiver operating characteristics compared the discrimination of prostate specific antigen, Prostate Health Index and other prostate specific antigen related biomarkers. Sensitivity and specificity for Gleason grade group 2-5 prostate cancer detection were assessed at prostate specific antigen and Prostate Health Index thresholds alone and in series.Results:Of biopsied subjects 32.9% had Gleason grade group 2-5 prostate cancer. In Blacks with prostate specific antigen from 4.0–10.0 ng/ml, Prostate Health Index and prostate specific antigen had similar discrimination for Gleason grade group 2-5 prostate cancer (0.63 vs 0.57, p=0.27). In Blacks with prostate specific antigen ≤10.0, a threshold of prostate specific antigen ≥4.0 had 90.4% sensitivity for Gleason grade group 2-5 prostate cancer; a threshold of prostate specific antigen ≥4.0 with Prostate Health Index ≥35.0 in series avoided unnecessary biopsy in 33.0% of men but missed 17.3% of Gleason grade group 2-5 prostate cancer. Prostate specific antigen ≥4.0 with Prostate Health Index ≥28.0 in series spared biopsy in 17.9%, while maintaining 90.4% sensitivity of Gleason grade group 2-5 prostate cancer.Conclusions:The Prostate Health Index has moderate accuracy in detecting Gleason grade group 2-5 prostate cancer in Blacks, but Prostate Health Index ≥28.0 can be safely used to avoid some unnecessary biopsies in Blacks.
This article describes an educational program to engage African American men as citizen scientist... more This article describes an educational program to engage African American men as citizen scientists (CSs) and future research partners in a lung cancer screening project. We provide an overview of the curriculum used, the structure and format of the educational sessions, and associated educational outcomes. Furthermore, we describe lessons learned in the engagement of African American men as CS in community-based lung-health equity research. The CS educational program included five group-based sessions delivered through zoom. The educational curriculum was adapted from the University of Florida Citizen Scientist program and tailored to address lung health and the contextual experiences of African American men. Each session lasted 90 minutes. Pre- and post-test measures were collected to examine changes in knowledge, comfort, health literacy, research interests, and medical mistrust. Eight African American men completed the CS educational program. Attendance rates were high for each s...
... Page 11. first chapter in volume 2 of UNESCO's eight volume General History of Africa... more ... Page 11. first chapter in volume 2 of UNESCO's eight volume General History of Africa (Mokhtar et al., 1990) in which Dr. Diop's article on the origin of the Ancient Egyptians (Mokhtar et al., p. 15-32) is prominent, much debate still exists. ... NJ: Al-Huda Foundation. ...
Progress in Community Health Partnerships: Research, Education, and Action, 2019
screening using PSA is standard of care, 5 there is marked overdiagnosis and overtreatment owing ... more screening using PSA is standard of care, 5 there is marked overdiagnosis and overtreatment owing to the relatively low specificity of PSA. 6,7 Ongoing controversies related to the risk versus benefit of PCa screening using PSA highlight overscreening, overtreatment, and increased morbidity related to potentially unwarranted biopsies and provider and patient uncertainty. 5-7 These controversies may further widen the PCa disparities gap among AAM.
Black men are disproportionately impacted by lung cancer morbidity and mortality. Low-dose helica... more Black men are disproportionately impacted by lung cancer morbidity and mortality. Low-dose helical computed tomography (LDCT) lung cancer screening has demonstrated benefits for reducing lung cancer deaths by identifying cancers at earlier, more treatable stages. Despite the known benefits, LDCT screening is underutilized in black men. Studies in racially heterogeneous populations have found correlations between screening behaviors and factors such as physician trust, physician referral, and a desire to reduce the uncertainty of not knowing if they had lung cancer; yet little is known about the factors that specifically contribute to screening behaviors in black men. Community engagement strategies are beneficial for understanding barriers to health-care engagement. One community engagement approach is the citizen scientist model. Citizen scientists are lay people who are trained in research methods; they have proven valuable in increasing communities’ knowledge of the importance of...
Prostate cancer (PCa) disproportionately affects African American men. Early detection reduces ri... more Prostate cancer (PCa) disproportionately affects African American men. Early detection reduces risk of mortality. The United States Preventive Services Task Force (USPSTF) issued an updated recommendation statement on serum Prostate Specific Antigen (PSA)-based screening for PCa. Specifically, in 2012, the USPSTF recommended against PSA-based screening due to risk for overdiagnosis and overtreatment. However, the updated 2018 guidelines recommend consideration of screening for certain at risk men and revised the recommendation rating from “D” to “C.” This new guideline recommends providers to educate high-risk men on the benefits and harms of PSA-based PCa screening so that they can make an informed decision. The Affordable Care Act (ACA) includes provisions of service coverage for patient navigators who can help patients decide whether screening is appropriate, given potential risks and benefits, and training of health care providers in shared-decision regarding screening/treatment...
Progress in Community Health Partnerships: Research, Education, and Action
screening using PSA is standard of care, 5 there is marked overdiagnosis and overtreatment owing ... more screening using PSA is standard of care, 5 there is marked overdiagnosis and overtreatment owing to the relatively low specificity of PSA. 6,7 Ongoing controversies related to the risk versus benefit of PCa screening using PSA highlight overscreening, overtreatment, and increased morbidity related to potentially unwarranted biopsies and provider and patient uncertainty. 5-7 These controversies may further widen the PCa disparities gap among AAM.
When I began to think about the idea of intelligence and achievement, I couldn’t help thinking ab... more When I began to think about the idea of intelligence and achievement, I couldn’t help thinking about the historical origins of the idea of intelligence, the nature of achievement and how these ideas intersect with the socially constructed notion of race. These assumptions have created the pathos of distance which was Nietzche’s way of differentiating the noble class from the servile based on social status and values. It is reflected in the ideas of Herbert Spencer and his social Darwinist and biological determinist views related to the concept of ‘good’. Those persons considered good were life preserving, brave, stout, well-bred, and morally good. They were aristocratic, brave, valiant and capable. Those persons (a dubious term since they were not considered people) whom did not have those characteristics were viewed as cowardly, vile, low-born, wretched, miserable, bad, evil, wicked, destructive, and mischievous.
Purpose:The Prostate Health Index is validated for prostate cancer detection but has not been wel... more Purpose:The Prostate Health Index is validated for prostate cancer detection but has not been well validated for Gleason grade group 2-5 prostate cancer detection in Black men. We hypothesize that the Prostate Health Index has greater accuracy than prostate specific antigen for detection of Gleason grade group 2-5 prostate cancer. We estimated probability of overall and Gleason grade group 2-5 prostate cancer across previously established Prostate Health Index ranges and identified Prostate Health Index cutoffs that maximize specificity for Gleason grade group 2-5 prostate cancer with sensitivity >90%.Materials and Methods:We recruited a “cancer-free” Black control cohort (135 patients) and a cohort of biopsy naïve Black men (158) biopsied for elevated prostate specific antigen. Descriptive statistics compared the prostate cancer cases and controls and the frequency of Gleason grade group 2-5 prostate cancer across Prostate Health Index scores. Receiver operating characteristics compared the discrimination of prostate specific antigen, Prostate Health Index and other prostate specific antigen related biomarkers. Sensitivity and specificity for Gleason grade group 2-5 prostate cancer detection were assessed at prostate specific antigen and Prostate Health Index thresholds alone and in series.Results:Of biopsied subjects 32.9% had Gleason grade group 2-5 prostate cancer. In Blacks with prostate specific antigen from 4.0–10.0 ng/ml, Prostate Health Index and prostate specific antigen had similar discrimination for Gleason grade group 2-5 prostate cancer (0.63 vs 0.57, p=0.27). In Blacks with prostate specific antigen ≤10.0, a threshold of prostate specific antigen ≥4.0 had 90.4% sensitivity for Gleason grade group 2-5 prostate cancer; a threshold of prostate specific antigen ≥4.0 with Prostate Health Index ≥35.0 in series avoided unnecessary biopsy in 33.0% of men but missed 17.3% of Gleason grade group 2-5 prostate cancer. Prostate specific antigen ≥4.0 with Prostate Health Index ≥28.0 in series spared biopsy in 17.9%, while maintaining 90.4% sensitivity of Gleason grade group 2-5 prostate cancer.Conclusions:The Prostate Health Index has moderate accuracy in detecting Gleason grade group 2-5 prostate cancer in Blacks, but Prostate Health Index ≥28.0 can be safely used to avoid some unnecessary biopsies in Blacks.
This article describes an educational program to engage African American men as citizen scientist... more This article describes an educational program to engage African American men as citizen scientists (CSs) and future research partners in a lung cancer screening project. We provide an overview of the curriculum used, the structure and format of the educational sessions, and associated educational outcomes. Furthermore, we describe lessons learned in the engagement of African American men as CS in community-based lung-health equity research. The CS educational program included five group-based sessions delivered through zoom. The educational curriculum was adapted from the University of Florida Citizen Scientist program and tailored to address lung health and the contextual experiences of African American men. Each session lasted 90 minutes. Pre- and post-test measures were collected to examine changes in knowledge, comfort, health literacy, research interests, and medical mistrust. Eight African American men completed the CS educational program. Attendance rates were high for each s...
... Page 11. first chapter in volume 2 of UNESCO's eight volume General History of Africa... more ... Page 11. first chapter in volume 2 of UNESCO's eight volume General History of Africa (Mokhtar et al., 1990) in which Dr. Diop's article on the origin of the Ancient Egyptians (Mokhtar et al., p. 15-32) is prominent, much debate still exists. ... NJ: Al-Huda Foundation. ...
Progress in Community Health Partnerships: Research, Education, and Action, 2019
screening using PSA is standard of care, 5 there is marked overdiagnosis and overtreatment owing ... more screening using PSA is standard of care, 5 there is marked overdiagnosis and overtreatment owing to the relatively low specificity of PSA. 6,7 Ongoing controversies related to the risk versus benefit of PCa screening using PSA highlight overscreening, overtreatment, and increased morbidity related to potentially unwarranted biopsies and provider and patient uncertainty. 5-7 These controversies may further widen the PCa disparities gap among AAM.
Black men are disproportionately impacted by lung cancer morbidity and mortality. Low-dose helica... more Black men are disproportionately impacted by lung cancer morbidity and mortality. Low-dose helical computed tomography (LDCT) lung cancer screening has demonstrated benefits for reducing lung cancer deaths by identifying cancers at earlier, more treatable stages. Despite the known benefits, LDCT screening is underutilized in black men. Studies in racially heterogeneous populations have found correlations between screening behaviors and factors such as physician trust, physician referral, and a desire to reduce the uncertainty of not knowing if they had lung cancer; yet little is known about the factors that specifically contribute to screening behaviors in black men. Community engagement strategies are beneficial for understanding barriers to health-care engagement. One community engagement approach is the citizen scientist model. Citizen scientists are lay people who are trained in research methods; they have proven valuable in increasing communities’ knowledge of the importance of...
Prostate cancer (PCa) disproportionately affects African American men. Early detection reduces ri... more Prostate cancer (PCa) disproportionately affects African American men. Early detection reduces risk of mortality. The United States Preventive Services Task Force (USPSTF) issued an updated recommendation statement on serum Prostate Specific Antigen (PSA)-based screening for PCa. Specifically, in 2012, the USPSTF recommended against PSA-based screening due to risk for overdiagnosis and overtreatment. However, the updated 2018 guidelines recommend consideration of screening for certain at risk men and revised the recommendation rating from “D” to “C.” This new guideline recommends providers to educate high-risk men on the benefits and harms of PSA-based PCa screening so that they can make an informed decision. The Affordable Care Act (ACA) includes provisions of service coverage for patient navigators who can help patients decide whether screening is appropriate, given potential risks and benefits, and training of health care providers in shared-decision regarding screening/treatment...
Progress in Community Health Partnerships: Research, Education, and Action
screening using PSA is standard of care, 5 there is marked overdiagnosis and overtreatment owing ... more screening using PSA is standard of care, 5 there is marked overdiagnosis and overtreatment owing to the relatively low specificity of PSA. 6,7 Ongoing controversies related to the risk versus benefit of PCa screening using PSA highlight overscreening, overtreatment, and increased morbidity related to potentially unwarranted biopsies and provider and patient uncertainty. 5-7 These controversies may further widen the PCa disparities gap among AAM.
When I began to think about the idea of intelligence and achievement, I couldn’t help thinking ab... more When I began to think about the idea of intelligence and achievement, I couldn’t help thinking about the historical origins of the idea of intelligence, the nature of achievement and how these ideas intersect with the socially constructed notion of race. These assumptions have created the pathos of distance which was Nietzche’s way of differentiating the noble class from the servile based on social status and values. It is reflected in the ideas of Herbert Spencer and his social Darwinist and biological determinist views related to the concept of ‘good’. Those persons considered good were life preserving, brave, stout, well-bred, and morally good. They were aristocratic, brave, valiant and capable. Those persons (a dubious term since they were not considered people) whom did not have those characteristics were viewed as cowardly, vile, low-born, wretched, miserable, bad, evil, wicked, destructive, and mischievous.
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