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2023 American Cancer Society (ACS) – PCF Young Investigator Award

Rural Outpatient Advanced Diagnostics to Maximize Access to Prostate Health (ROADMAP)

Alexander P. Cole, MD

Mentors: Quoc-Dien Trinh, Caroline M.Moore, Adam S. Kibel

Description:

  • Patients with prostate cancer who live in rural communities face unique challenges, including reduced access to advanced diagnostics and targeted interventions. The extent and magnitude of this disparity, as well as whether these disparities are due to referral patterns, patient preferences, or other health systems factors, are unknown.
  • Dr. Alexander Cole is investigating the nature of disparities in access to modern prostate cancer care in rural settings.
  • In this project, Dr. Cole and team will use Medicare and the American Hospital Association (AHA) databases to assess geographic disparities (urban vs. rural) in utilization of diagnostics and targeted interventions, such as image-guided biopsies, image-guided treatments, and molecularly targeted therapies, such as PARP inhibitors for patients with germline mutations. The role of geography, hospital type, insurance type, and health systems factors in receipt of advanced testing and targeted interventions will be determined.
  • The contribution of regional, hospital, and patient level variables on race-specific likelihood of receiving advanced testing and targeted interventions will also be investigated. Barriers to advanced testing and targeted interventions at community practices treating underserved minority patients will be identified.
  • If successful, this project will identify modifiable factors that impact receipt of advanced imaging and molecular diagnostics by rural prostate cancer patients. Ultimately, this proposal aims to yield a policy and implementation roadmap to facilitate the equitable dissemination of prostate cancer diagnostic and treatment modalities with a particular emphasis on rural populations.

What this means to patients: Patients in rural communities tend to have reduced access to advanced diagnostics and targeted interventions for prostate cancer, which contributes to disparities in health outcomes. Dr. Cole and team aim to determine the nature of disparities in access to modern prostate cancer care in rural settings and develop a policy and implementation roadmap for equitable diffusion of advanced diagnostics and targeted interventions. This will contribute to more equitable and high-quality cancer care for all patients with prostate cancer regardless of race, ethnicity, or geographic location.