DOD: Prostate Barbers Cut to the Chase in Minority Prostate Cancer Awareness

ATLANTA, Sept. 7 -- Although barbers and surgeons long been linked in the history of medicine, the role of urologist's assistant is a new twist. Now the barbershop is becoming a clearinghouse for minority prostate cancer screening.

The barbershop -- a minority community gathering spot -- has been converted into an education resource in more than 100 sites across the country, resulting in thousands of black men seeking screening.

"In minority communities -- particularly low-income inner-city areas -- the barbershop has become a sort of clubhouse for men," said Virgil Simons, founder and president of Prostate Net, who used the cultural phenomenon to promote prostate screening.

Beginning in 2004, and using the success of the "Barbershop" movies that starred Ice Cube and Cedric the Entertainer, Simons persuaded various groups to start a prostate cancer outreach to the African-American community.

"Prostate cancer affects black men in both incidence and mortality at much higher rates than white men," Simons said in an oral presentation at the Department of Defense Prostate Cancer Research Program meeting.

"In 1997 to 2001, black men in the United States had an average annual age-adjusted prostate cancer incidence rate of 271.3 per 100,000, 62% higher than the rate of 167.4 per 100,000 for white men," he said. "An even more striking disparity exists in mortality; for the same period the average annual age-adjusted prostate cancer mortality rate for American black men, 70.4 per 100,000, was nearly two and a half times the rate for white men, 28.8 per 100,000."

Simons recruited 27 hospitals in the inner city areas who agreed to provide free prostate cancer screenings. He got 500 barbers to distribute educational materials and discuss prostate issues. "We trained the barbers to perform as a trusted health care motivator," Simons said. "In many minority communities, the barber represents a figure more trusted than a doctor."

The program resulted in 10,034 men undergoing screening, and 442 malignancies found. Under the program, the hospitals agreed to treat the men with cancer even if the men did not have health insurance.

In 2005, the nationwide program had spread to 78 regional hospitals and 800 barbers were cutting hair and talking prostate issues with their clients. "Men will talk about issues in a barber shop with their barbers and friends that they would never talk about with their wives or even their doctors," Simons said. About 12,700 men were screened through the program, and more than 500 cancers were detected, Simons said.

In addition at least as many other prostate issues such as benign prostatic hyperplasia were discovered, Simons said. The screening also found many men with untreated hypercholesterolemia and diabetes.

By 2006, more than 100 institutions and close to 900 barbers were participating in the program. Figures for screening and outcomes are still being compiled, Simons said.

He said the innovative program has a feedback loop that increases confidence of African-Americans in the medical institutions and as a result has improved participation by African-Americans in clinical trials that are undertaken by the hospitals.

New tweaks in the program involve adding computer stations in selected barbershops to give customers access to prostate cancer questions. The program is funded by private foundations, government organizations, industry, pharmaceutical companies and donations from individuals, Simons said.

The success of the barbershop program led Lori Gordon, a post-graduate researcher at Florida A&M University in Tallahassee to perform exploratory studies using similar tactics in beauty salons. "Women are the gatekeepers for family health," she said.

She suggested that by discussing prostate cancer treatment and screening in beauty salons, women would encourage their husbands or male partners to seek medical help.

"You need to go out into the community to get people to participate in these programs," commented Col. Janet Harris, Ph.D., RN, director of the Congressionally Directed Medical Research Programs. "If you want these people to come to you, it's not going to happen."

"The results we have seen in the Prostate Net program appear to show that it has been successful," Col. Harris said. "Verbal referral is good advertising."