Prostate cancer is the most common cancer in the United States. African
American men, particularly those with a family history of prostate
cancer, have the highest incidence and the highest death rate of all
men nationwide. A study was recently conducted which showed that men
whose brothers or fathers had prostate cancer are at a 2-3 fold increased
risk of getting prostate cancer. In this study, some families were
identified that had multiple family members
affected with prostate cancer. Our goal is to provide information
and data to researchers who are studying genetic make up of these
families in order to better understand how this disease may be inherited.
You have been asked to participate in this project because you are
a physician with prostate cancer patients or your family has several
members affected with prostate cancer.
Project Mission: The National
Physician & Family Referral (NPFR) Project is a national physician,
community and media outreach for patient recruitment and public awareness
of prostate cancer in support of national human genome studies. Our
mission is to focus on studies that are geared toward the effect prostate
cancer has on the African American male population nationally and
abroad. We recruit families who meet the criteria for national and
international human genome research.
Project Goal: Our goal is to identify prostate
cancer survivors and family members who will act as "contacts" for
the family in this human genome recruitment effort. We want to identify
families that have 2, 3 and 4 family members (father, brother, uncle,
cousin, grandfather, etc.) that have been diagnosed with prostate
cancer. Initially, we are looking for 10-20 families that include
4 or more prostate cancer patients. However, all family contacts will
be surveyed.
Please choose the appropriate form by clicking the link on left.
If you are a physician who has African American patients with Prostate Cancer in the family, please click
on'Physician Survey Form'.
If you are African American patient or family member of Prostate Cancer patient, please click on'Family Referral Survey Form'.
NPFR relies on voluntary participation by physicians and family members.
The questionnaires ask about general health and medical history. All
information collected is confidential. It takes about one minute to
complete the questionnaire. Once completed, please click on the "submit"
button at the bottom of the page or print the form and fax to 1-775-628-2061.
There is no pay or compensation for your participation in this survey/project.
Your participation is completely voluntary, but we hope you will be
willing to take part in this historic study. The results of this project
are turned over to the National Human Genome researchers who will
contact the physician of families who meet the criteria. If you have
questions, please call 1-800-677-8441.
Thank you for taking the time to complete this questionnaire. Your
participation is greatly appreciated.
