Prostate Cancer Awareness among Black Ethnic Minorities - Essay Example

Pro Cancer Awareness among Black Ethnic Minority Population Supportive Essay The ultimate purpose of Healthcare Providers (HCPs) is the extension of non-discriminatory health services to all individuals.This implies that the age or ethnic is no barrier to access health facilities. Despite the noble intention of the healthcare community, this is not always the situation since at least in the situation of the black communities and minorities. It is increasingly becoming complicated to offer health services with the ever-changing multicultural world. With over 913,000 people diagnosed with cancer all over the world, one has to agree that it presents a real concern to the health fraternity (Kheirandish & Chinegwundoh, 2011, p 481). In the United Kingdom alone, 35,000 men are diagnosed with prostate cancer each year with 10,000 others dying from the diseases (The Prostate Cancer Charity, n.d., p1). According to NCIN (2013) report, the rate of cancer incidence in the four countries in the UK increased significantly between 2008 and 2010 as compared to the period between 1993 and 1995. The report also suggested that 22.7-23.9 was the mortality rate between 2008 and 2010 (NCIN, 2013, p1). The fall in the mortality rate can be attributed to the rise in the number of people accessing PSA testing thus enabling early detection and identification of non-aggressive cancer (Moore et. al., 2009, p1594). According to Carter (2013), early detection is the best chance at reducing prostate cancer mortality rate (p 543). In spite of all the increased access to prostate cancer due to increased awareness among the UK citizens, the BME groups continue to exhibit worrying trends. NHS (2012, para. 1) estimates that 40,000 new cases of prostate cancer are diagnosed in the UK. According to the Parliamentary Stakeholder Group (2012) report, the Black Caribbean and the Black African men living in the UK are thrice more vulnerable to getting prostate cancer than the white male. Other than the prevalence of the disease among the BME communities, the other worrying aspect of prostate cancer is the low awareness within this population. The Parliamentary Stakeholder Group (2012) report also states that only 37% of UK’s black males were aware of the existence of the disease in 2007. This is a grim figure compared to the 64% of the white male population within the same time and place. The report also suggests that only 15% of African Caribbean men were aware of their high susceptibility to the disease. The rate of prostate cancer incidence and mortality from the disease is highest in the black communities. The inequality in the delivery of cancer services to the black minority ethnic communities has led to deaths due to late diagnoses. Prostate cancer among the black minority ethnic (BME) groups is particularly a reason to worry. The barriers that have hindered effective delivery of health services to the BME groups include “poor knowledge, underlying health and cultural beliefs, attitudes, language and unhelpful attitudes of health professionals” (NCIN and Cancer research UK, 2009, p14). These socioeconomic factors present the highest threats and weaknesses of the current system of addressing prostate cancer in BME communities. Along with prostate cancer, the BME communities are highly vulnerable to other forms of cancer such as breast, cervical, and stomach cancer. In comparison to their white male counterparts, black men are three times more likely to get prostate cancer (NCIN and Cancer research UK, 2009, p1). Kheirandish and Chinegwundoh (2011) also seem to agree with the fact that black men have a higher chance of getting prostate cancer than the white men (p.481). There is a consensus among researchers that genetic mutations in black men along with excessive production of sebum are the main risk factors that predispose black men to prostate cancer (Kheirandish & Chinegwundoh, 2011, p56). Odedina et. al. (2009) suggest that the disparities are also different among the different BME communities. The genetic disposition and hormones of the African-Americans have been their primary undoing when it comes to their vulnerability to getting prostate cancer. Hormones that are mainly associated with prostate cancer include testosterone, dehydrotestosterone, and 5-alpha reductase. All these hormones are predominant in black male than in the white male. Despite the fact that some earlier researchers found no relationship between the two, other findings have suggested otherwise. The conclusion on the relationship between ethological factors thus remains inconclusive (Kheirandish and Chinegwundoh, 2011, p 484). Increasing awareness among the BME communities is seen as the best way to start the intensive efforts of reducing prostate cancer within this group. Given the fact that these communities tend to stay in centralized position implies that reaching them should not pose a challenge to the awareness efforts. However, the cultural beliefs and cancer misconceptions might pose a serious obstacle to these efforts. This calls for active community engagement to reach the men of the BME communities (Parliamentary Stakeholder Group, 2012, p8). Social events such as comedy clubs and leaflets can be tailored to the preferences of these communities and used to raise awareness. This approach ensures that the information presented to the BME community is specific and familiar to their prostate cancer situation. While the distribution and availability of cancer screening services can be blamed for the low access among the BME communities, the reality contrasts. HCPs, unlike common belief, are not widely involved in discriminatory activities within the workplace. With the exception of few, most HCPs remain professional and ethical in their line of duty. The reasons why most members of the BME groups fail to get adequate screening facilities is down to their own beliefs and perceptions. There is the a need to raise cancer awareness among all minority ethnic groups. The increased awareness should focus on the types of cancer, which each group is more vulnerable to. For instance, the cancer awareness in the BME communities should be concentrated on cervical cancer, stomach cancer, and most importantly prostate cancer. According to Knight (2012), the level of screening of prostate cancer among the black communities has been lower than that in the white population despite the high prevalence in the former (p17). Other than screening, the other barrier to cancer prevention and management outlined by should be considered to reverse the trend in the BME population. There should be intensified effort on emancipating the BME communities on the importance of taking up cancer screening and quelling the prevailing health and cultural beliefs. These beliefs have gone a long way in impeding the progress towards eradicating prostate cancer. The misconceptions, attitudes, language and unhelpful attitudes of health professionals should also be addressed to increase access of prostate cancer services in the BME groups (Thomas et. al., 2005, p571). Evans et. al. (2008) and Evans et. al. (2010) agree that the case of prostate cancer in black male is down to low awareness rather than genetic predispositions. While the black men have been said to have more prostate cancer than the white men due to genetic and hormonal differences, the facts still remain with the jury to resolve. However, it is clear is the fact that the BME communities have less access to cancer services such as screening. There is a good chance that if the barriers to access are removed, more black men will be able to get prostate cancer screening. The data on the relationship between the rates of incidence of prostate cancer among the black population has not been empirically proven since the low awareness provides statistical imbalance in the comparison. Until the issue of awareness is addressed, and fair level knowledge and awareness established across all ethnicities, the current data will remain inconclusive. Equality in access of cancer services across the ethnicities is likely to lead to similar outcome in the rate of prevalence, prevention, and treatment Kheirandish and Chinegwundoh, 2011, p484). HCPs are, therefore, challenged to have a dedicated initiative that is aimed to raise awareness, intensify screening uptake, and contest the cancer myths deeply rooted in the BME communities (Knight, 2012, p108). The NCAT campaign is one of such initiatives that are aimed at resolving the ethnic cancer-screening gap. The Department of Health (2009) accepts that the reservations BME patients are to some extent justified. According to their 2009 report, some BME patients complained of receiving poor service relative to the white patients in the public hospitals. This creates the need to investigate the healthcare practitioners who have embraced a selective approach to delivering health services thus stunting any progress being made to increase prostate awareness and screening access among the BME population. Despite the NHS of England has tried to address the issue of health access disparity among the different ethnic groups, there still remains need to have better data collection (Parliamentary Stakeholder Group, 2012, p9). This will not only help estimate the rate of incidence and mortality, but provide a realistic picture on the connection between the prostate cancer and the ethnicity.Other than data collection, the other aspect of prostate awareness that should be embraced is the empowerment of patients. Strategic steps should be taken to ensure that the health professionals are engaged for a rounded approach to enhancing awareness among the BME groups in the UK. The cancer campaigns that are tailored for the BME groups will greatly benefit from the use of accurate data to present facts and support from qualified HCPs’ insight. This is the reason the contribution of these two factors is integral to increasing awareness among the BME communities. According to the Institute of Medicine, the 370,000 new cases of prostate cancer diagnosed can be substantially increase if the black communities are more engaged in the awareness programs (Cancer Research UK, 2014, p1). The increase in diagnosis should not be viewed as an entirely bad trend since it is a testimony of the increased awareness rather than a case of increased incidence. Commercial radio and targeted information are the best means of reaching this minority group and presenting them with the actual details of prostate cancer. Black men of West African and African Caribbean African origin have lower awareness of prostate cancer than the white men (Ben-Shlomoet et. al., 2008, p103). With only 37% of Black men having heard of prostate cancer compared to 64% of White men, it is clear that more need to be done by healthcare providers to revert the trend (Ben-Shlomoet et. al., 2008, p103). In 2008, research ordered by The Prostate Cancer Charity 58% of African Caribbean men described prostate cancer as the most common form of cancer in men. This is a pale contrast to the 69% of the thoughts of the general population in a separate research by The Prostrate Cancer Charity. The low level of awareness is further exhibited in the fact that only 15%of the African Caribbean men are aware of their increased risk of getting prostate cancer (The Prostate Cancer Charity, n.d., p5). This only goes to emphasize the importance of improving awareness among the BME communities. In an awareness effort, there will be a specific focus on the incidence, mortality, and survival of prostate cancer among BME communities. The awareness will focus on emancipating the BME communities and removing all misconceptions that are related to prostate cancer within the Black Caribbean and Black African men. Having identified underlying health and cultural beliefs, attitudes, language and unhelpful attitudes of health professionals as the impediments to awareness, the campaign by healthcare providers will focus on these factors. The HCPs will also focus on addressing the barriers to the presentation such as embarrassment, fear, pride, and loss of dignity (Ross, 2009, p22). The encouraging part of the campaign is the fact that many men of the BME communities are willing to participate. In a similar 2009 awareness by Thompson Ross (2009), the participation significantly increased after initially reaching 120 men in 2 months (p.26).With 92% of participants admitting to have learned something of value during the program and 100% agreeing to take action, it is clear that this plan is enforceable (Ross, 2009, p24). According to Lawton (2012), the model used to treat prostate cancer is the UK and across Europe is affordable. Despite the cost effective nature of cancer diagnosis, the patients still shy away from the services. This can only be explained by factors other than financial. SWOT Analysis of Current UK Prostate Cancer Situation STRENGTH There is adequate moral and financial support from the government and Non-Governmental Organizations (NGOs) to support cancer awareness among the BME groups The cost of diagnosis, relative to countries such as US, is cost effective WEAKNESES There are still barriers such as underlying health and cultural beliefs, attitudes, language The unhelpful attitudes of health professionals has discouraged some people from accessing these services OPPORTUNITIES The members of the BME communities have been responding to Community based programs There is support from the healthcare practitioners to support the fight THREATS There is the probability that most of the funds dedicated for cancer will not be directed to prostate cancer awareness among the BME groups The data that is currently available on BME groups’ cancer incidence, mortality, survival, and reasons for higher prevalence is inadequate. Awareness Poster HOW MUCH DO YOU KNOW OF PROSTATE CANCER WITHIN THE BLACK MINORITY ETHNIC GROUPS? Have you been enlightened of the fact that prostate cancer is the most commoncancer among males in all the four countries of the UK? Are you aware that BME community men are three times more vulnerableto getting prostate cancer then the white males? Do you know that in 2011 alone, 41,736men in the UK were diagnosed with cancer? Do you realize that the age standardized rates for the Black males was the highest among ethnic groups at 120.8 to 247.9 per 100,000in 2011? This is a wakeup call to all men within the BME communities to actively take up the fight against PROSTATE CANCER. Check out for the following symptoms to access your prostare cancer position; Difficulty in starting to relieve yourself Frequently having the urge to go for a short call Experiencing weak urine flow Having the sense that you have not completely emptied the bladder When you experience any of these symptoms, it is wise that you consult a physician. While all the symptoms do not necessarily imply that one has prostate cancer, why would one take the risk with a disease that was responsible for an estimated 10,773 deaths in 2010 in the UK alone? DON’T RISK IT! SEEK EARLY DIAGNOSIS TODAY! Bibliography Bahl, A., Wylie, J., Malik, Z., Masson, S., Bono, J. D., Chowdhury, S., et al. (2013). 715 CabazitaxelFor Metastatic Castration Resistant Prostate Cancer (Mcrpc): Final Quality Of Life (Qol) Results With Safety Data From The United Kingdom (Uk) Early Access Programme (Eap) (Nct01254279). The Journal of Urology,189(4), e294.Department of Health (2009) Report on the Self-reported Experience of Patients from Black and Minority Ethnic Groups 2009.London: DH. tinyurl.com/DH-BME-experience. Ben-Shlomo, Y., Metcalfe, C., Chinegwundoh, F., Anson, K., Patel, B., Ibrahim, F., et al. (2008). The Risk of Prostate Cancer amongst Black Men in the United Kingdom: The PROCESS Cohort Study. European Urology, 53(1), 99-105. Cancer Research UK (2014) Prostate Cancer: Cancer Statistics, Key Facts. Retrieved from http://publications.cancerresearchuk.org/downloads/Product/CS_KF_PROSTATE.pdf Carter, H. B. (2013). American Urological Association (AUA) Guideline on prostate cancer detection: process and rationale. BJU International, 112(5), 543-547. Department of Health (2009) Report on the Self-reported Experience of Patients from Black and Minority Ethnic Groups 2009.London: DH. tinyurl.com/DH-BME-experience. Evans S, Metcalfe C, Ibrahim F, Persad R, Ben-Shlomo Y (2008) ‘Investigating Black – White differences in prostate cancer prognosis: a systematic review and meta-analysis’. International Journal of Cancer, 123, pp. 430 – 435. Evans S, Metcalfe C, Patel B, Ibrahim F, Anson K, Chinegwundoh F, Corbishley C, Gillatt D, Kirby R, Muir G, Nargund V, Popert RP, Persad R, Ben-Shlomo Y (2010) ‘Clinical presentation and initial management of Black men and White men with prostate cancer in the United Kingdom: the PROCESS cohort stud’. Br J Cancer102:pp. 249 – 254 Kheirandish, P. and Chinegwundoh, F..(2011) ‘Ethnic differences in prostate cancer’.British Journal of Cancer, 105,pp. 481 – 485. Knight L.P. (2012) Raising cancer awareness in minority ethnic groups. Nursing Times; 108: 38, pp. 17-19. Lawton, C. (2012). Cost-Effectiveness of Prostate Specific Antigen Screening in the United States: Extrapolating From the European Study of Screening for Prostate Cancer. Yearbook of Oncology, 2012, 86-87. Moore, A. L., Dimitropoulou, P., Lane, A., Powell, P. H., Greenberg, D. C., Brown, C. H., et al. (2009). Population-based prostate-specific antigen testing in the UK leads to a stage migration of prostate cancer. British Journal of Urology international, 104, 1592-1598. Muneer, A., &Blacklock, A. (2010). PSA Screening for Prostate Cancer in United Kingdom – Over A 4 Year Period.International Journal of Surgery, 8(7), 537. National Cancer Intelligence Network.(2013). Prostate Cancer Incidence, Mortality and Survival Rates in the United Kingdom.Retrieved from http://www.ncin.org.uk/view?rid=1004 National Cancer Intelligence Network (2009) Cancer Incidence and Survival by Major Ethnic Group, England, 2002–2006. London: NCIN. www.ncin.org.uk/view.aspx?rid=75 National Cancer Intelligence Network and Cancer Research. Black People At Greater Risk Of Prostate And Stomach Cancers :Birmingham. 25 June, 2009. NHS (2012). Prostate Cancer: Prostate cancer is the most common cancer in men in the UK, with over 40,000 new cases diagnosed every year.Retrieved from http://www.nhs.uk/conditions/cancer-of-the-prostate/Pages/Introduction.aspx Odedina FT, Akinremi T, Chinegwundoh F, Roberts R, Yu D, Reams R, Freedman M, Rivers B, Lee Green B, Kumar N (2009) ‘Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa’. Infect Agent Cancer 4(Suppl 1): S2; e-pub ahead of print 10 February 2009; doi:10.1186/1750-9378-4-S1-S2 Parliamentary Stakeholder Group.(2012). Prostate Cancer in BME Communities: Raising Awareness and Improving Outcomes. Ross, T. (2009).Prostate Cancer Awareness Raising in Nottingham’s African Caribbean Community. Nottingham. Retrieved from https://www.york.ac.uk/media/healthscience/documents/research/Thompson%20Workshop.ppt The Prostate Cancer Charity.(n.d). Response on behalf of The Prostate Cancer Charity to the call for evidence on cancer inequalities from the APPG on cancer.Retrieved from http://prostatecanceruk.org/media/228142/appgresponse.pdf The Prostate Cancer Charity (2009). Hampered by Hormones? Addressing the needs of men with prostate cancer, Campaign Report, 2009. Read More