The Man Van: A pilot study of using mobile targeted case-finding to address health inequalities in prostate cancer.
Masood MoghulAmina TranFionnuala CroftNetty KinsellaClare PeckittDeclan CahillNicholas D JamesPublished in: International journal of cancer (2024)
Early diagnosis remains a major limitation of cancer outcomes with ethnicity and deprivation being determinants of inequalities that impact outcomes. Prostate cancer suffers from lower incidence rates and higher mortality rates in the most deprived versus the least deprived groups. We developed the 'Man Van' to enable high-risk male patients' from deprived communities and ethnic minorities increased access to health care to address these health inequalities. Between December 2021 and December 2022 the Man Van project was piloted in eight different locations chosen using geospatial targeting based on ethnic minority populations and deprivation scores. The primary outcome measures were the prevalence of prostate cancer and other health conditions. 810 men were recruited to be seen at our Man Van clinics with 610 men attending. 48% of attendees were non-White including 30% of men who were Black. 420 men had PSA tests performed with a median PSA of 1 μg/L. 15 prostate cancers were diagnosed (3.6%; 95% CI 2.0-5.9) with 10 of these being clinically significant disease. Black men were more likely to be diagnosed compared to white men: 7.1% versus 1.8% (p < .05). The Man Van project is a novel approach to tackling health inequalities combining awareness raising, improved access to healthcare as well as ease of follow-up. Comparatively high levels of prostate cancers were diagnosed at early stages and high levels of other health conditions were found which could improve the economic value of the service.
Keyphrases
- prostate cancer
- healthcare
- radical prostatectomy
- public health
- mental health
- middle aged
- health information
- risk factors
- end stage renal disease
- human health
- newly diagnosed
- cancer therapy
- squamous cell carcinoma
- chronic kidney disease
- type diabetes
- coronary artery disease
- adipose tissue
- ejection fraction
- insulin resistance
- cardiovascular events
- climate change
- papillary thyroid
- childhood cancer
- lymph node metastasis
- tertiary care