Introduction: NJ has one of the most ethically and racially diverse populations in the United States. There are nine million people in NJ – 56% White, 20% Hispanic, 13% African American (AA) and 9% Asian. Despite this diversity, the discriminatory practice of “redlining” which withheld services and investment from specific neighborhoods has resulted in significant segregation in several NJ cities. Two urban centers in NJ – Newark and Trenton are examples of this segregation. Newark has a population of 318,431 with 50.8% AA, 34.8% Hispanic, 11.1% White and 1.8% Asian. Trenton has a population 92,063 with 50.9% AA, 34% Hispanic, 13.8% White and 1.1% Asian. Both cities have significant poverty and are in the lowest 3% of the states annual per capita income. We investigated the effect of the change by the USPTSF PSA guidelines in 2012 on the detection and mortality of prostate cancer in these two underserved urban centers. Methods: NJ State Cancer Registry was used to compare prostate cancer detection and mortality rates in from 2008- 2019. We specifically compared annual rates in Newark/ Essex County and Trenton/ Mercer County. The cohort of patients from 2008- 2012 was compared to the cohort from 2013-2019 to determine if there was a change due to PSA screening Results: The incidence of prostate cancer in Trenton was 1667 and Newark 3161 from 2008-2012. Age adjusted rate of prostate cancer was 166.2 whites and 303.7 AA in Trenton. The age adjusted rate of prostate cancer was 161.5 for whites and 221.5 for AA in Newark. The prostate cancer specific mortality was 21.1 for whites and 57.6 for AA in Trenton from 2008-2012. The prostate cancer specific mortality was 16.6 for whites and 48.3 for AA in Newark. The incidence of prostate cancer in Trenton was 2489 and Newark 5017 from 2013-2019. The age adjusted rate of prostate cancer was 134.4 for whites and 248.5 for AA in Trenton. The age adjusted rate of prostate cancer was 129.5 for whites and 192 for AA in Newark . The prostate cancer specific mortality was 14.8 for whites and 35.6 for AA in Trenton from 2013-2019. The prostate cancer specific mortality was 15.4 for whites and 37.5 for AA in Newark. Conclusions: Statewide rate of prostate cancer deaths in both white and AA has decreased in New Jersey since the initiation of the USPTSF guideline change in 2012. This decrease in mortality has been observed in both underserved Trenton and Newark. Better access to healthcare via Medicaid expansion and opportunities for earlier or more effective treatment may be areas that have improved outcomes and warrant further study. SOURCE OF Funding: None
