Collaborative education to advance equitable prostate cancer care in geographically diverse communities.

Abstract

9033 Background: Although 15%-19% of the US population resides in rural areas, less than 10% of oncologists practice there, driving significant inequities in prostate cancer care. Community clinicians face barriers including limited subspecialist access, multidisciplinary gaps, biomarker testing delays, and low clinical trial participation. As biomarker testing, imaging, and individualized treatments evolve, targeted education is vital to support evidence-based decision-making and equitable delivery. Methods: Talem Health implemented a multicomponent CME/CE-accredited initiative for community oncologists managing prostate cancer across the disease spectrum. The initiative featured a 1-hour virtual session at the 2025 Oncology Congress, a 7-session longitudinal Project ECHO (Extension for Community Healthcare Outcomes) telementoring series, and a 1-hour "lessons learned" online activity. Outcomes were assessed via mixed methods: quantitative pre/post-activity assessments and polling, and qualitative data from ECHO case discussions and interviews. Analyses evaluated changes in knowledge, competence, and planned behaviors using Chi-square tests and effect size calculations. Results: Over 600 clinicians participated; 91% were hematology/oncology specialists, 93% practiced in community/non-academic settings, and 90% served rural or underserved populations. Identified barriers included limited testing access (36%), treatment access challenges (27%), multidisciplinary gaps (25%), and guideline unfamiliarity (23%). Statistically significant improvements occurred across all knowledge and competence outcomes ( P < .05 to P < .01). Clinicians reported increased intent to incorporate genomic/germline testing; align nmCRPC decisions with guidelines; utilize combination strategies for mHSPC; personalize mCRPC therapy; and implement shared decision-making. Qualitative findings from the ECHO series emphasized the value of peer-to-peer learning. Participants reported higher confidence in managing complex cases and contextualizing new evidence within real-world practice. Ongoing needs were identified regarding risk stratification, rural access barriers, and artificial intelligence applications. Repeated participation in ECHO sessions enabled clinicians to apply new evidence across multiple patient cases over time, reinforcing clinical decision-making through iterative discussion and shared problem-solving. Conclusions: This longitudinal educational design effectively supported community oncologists, yielding meaningful gains in knowledge, confidence, and intended practice behaviors. These results demonstrate that tailored education can expand clinician capacity and improve care for patients with prostate cancer in rural and underserved settings.