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Addressing Urology Disparities Through Community Partnerships and Institutional Collaboration - Samuel Washington

November 19, 2025

Zachary Klaassen hosts Samuel Washington to discuss social determinants of health and healthcare disparities in urologic oncology. Dr. Washington defines social determinants as measurable factors including education, income, insurance status, and where people live, work, and play, which contribute to disparities across racial, socioeconomic, and geographic lines. His Prostate Cancer Foundation Young Investigator Award work leverages institutional resources and community partnerships to identify short-term interventions addressing these disparities. Dr. Washington emphasizes the importance of collaborating with existing community organizations rather than creating duplicative programs, highlighting successful models like CaPSURE and VA systems where improved access reduces disparities. The discussion underscores the critical role of urologic oncologists in driving community engagement through partnerships with local chapters, screening events, and community urologists to ensure patients receive early screening and access to care without falling through systemic cracks.

Biographies:

Samuel L. Washington III, MD, MAS, Urologist, Goldberg-Benioff Endowed Professorship in Cancer Biology, University of Southern California, San Francisco, CA

Zachary Klaassen, MD, MSc, Urologic Oncologist, Assistant Professor of Surgery/Urology at the Medical College of Georgia at Augusta University, Wellstar MCG, Georgia Cancer Center, Augusta, GA



Related Content:

Race-Conscious Medicine in Urology: Shifting from Race-Based Algorithms - Logan Galansky

Prostate Cancer Disparities: A Global Lens - Edward Christopher Dee

Transportation Barriers in Prostate Cancer Care: Addressing Racial and Geographic Disparities - Quoc-Dien Trinh & Muhieddine Labban

Precision Oncology Program for Cancer of the Prostate (POPCaP) - Matthew Rettig
Read the Full Video Transcript

Zachary Klaassen: Hi, I'm Zach Klaassen, Urologic Oncologist at the Georgia Cancer Center in Augusta, Georgia here on UroToday at the Prostate Cancer Scientific Retreat in Carlsbad, California. I'm joined by Dr. Sam Washington, who is a Urologic Oncologist at UCSF in San Francisco. Sam, thanks as always for joining us on UroToday.

Samuel L. Washington III: Yeah, thanks for taking the time. Happy to chat.

Zachary Klaassen: Absolutely. So we're going to touch on a 30 hour topic, no, 10 minute topic on social determinants of health in urology and healthcare disparities, which is an obviously important topic. We're going to hit on some high-level points, but just tell us at a high level, from your standpoint, what are the disparities and what does that mean and what do social determinants mean in urology?

Samuel L. Washington III: Yeah, I think there's a few different ways that they're defined in our literature. Often it's defined by the things we can easily measure, education, income, insurance status, and we think of where people live, work, and play. When we pull that out and think of the social and then the structural aspects of those drivers, policy, local economics, you start to add all these layers that end up causing the outcomes and disparities that we see those differences in treatment and outcomes. So when we think about that broadly in those layers, that's how we think of those social and structural drivers of health.

Zachary Klaassen: And in your opinion, disparities in let's say prostate cancer specifically, what sort of is the number, say one, two, and three things in terms of disparities that you guys have done a lot of work on over the last decade or so?

Samuel L. Washington III: Yeah, I think there's obvious disparities across racial groups, disparities across socioeconomic lines, and disparities by geographic differences. What we're seeing where I grew up in Texas, going to be different than what I see in California. And I think we all identify those things, how we measure it, how we act on it, I think is the part where we're getting closer to that.

Zachary Klaassen: And so as I mentioned, you guys have done a lot of great work, and part of your YIA work has been in looking at this. So maybe just take your time, lay out what you guys have done, some of the high level stuff and the important stuff that you guys have done through the PCF to sort of tackle this problem.

Samuel L. Washington III: Yeah, I think I've been able to thankfully build and learn from the expertise in my own UCSF family, Dr. Carroll, Dr. Cooperberg's work with CaPSURE, understanding what's happening broadly in community practices, showing that when people have that access, the disparities decrease. Same thing that we're seeing in the VA. In our own institution, we're able to now look at this and understand where there may be opportunities for improvement. And I think that has provided opportunities for collaboration with my epidemiology colleagues to really understand these different levels, and that really set the stage for us now how do we collaborate and move towards intervening.

Zachary Klaassen: Yeah. And so your PCFYI award, what specifically have you been looking at that? How did that sort of set you up for the success in your early part of your career?

Samuel L. Washington III: Yeah, I think I was very fortunate to have strong mentorship and sponsorship within my department, within urology, but then outside, and I always say it's kind of 50/50, how that came about. And that was really support from Dr. Kim Rhoads, Dr. Scarlett Gomez, Salma Shariff-Marco, and the community partners. And my PCF is kind of the combination of all those sponsors and mentors coming together and how do we use institutional resources and community partnerships to really understand what's happening in our catchment area.

Zachary Klaassen: And I think the really $64,000 question is how do we make short-term changes? How do we make long-term changes, whether it's policy, whether it's implementation? What are your thoughts on both the short and long-term?

Samuel L. Washington III: Yeah, I think the long-term really is what a lot of times we're focused on that 10, 20, 30 year goal. And I'm not sure we have always clear short-term goals to get us there. We publish and talk about the long-term goals, and that's where I'm grateful to PCF for funding this work for us to identify those short-term targets. And how do we, again, use all these different inputs to measure, assess, intervene on those short-term goals?

Zachary Klaassen: I look at in my state, we have a very remote area, high density of underrepresented minorities and even partnering with community centers, with churches, screening fairs. How does this role at the grassroots level, how do we incorporate more of that into not just primary care into our cancer centers? What are your thoughts on that?

Samuel L. Washington III: Yeah, I think it was something that I didn't realize until I was almost a fellow working with these organizations outside of the research space, and I realized they've been doing all this supportive work this entire time. And it's not so much that we need to create a new, for me, for example, UCSF branded thing, but how do we collaborate and not duplicate efforts? How do we really drill down how we can help patients at our institution and outside get connected with the other groups that have been helping support them this whole time?

Zachary Klaassen: Yeah, that's super important. And there's so much from either ZERO Prostate Cancer, obviously PCF, but even outside some of these other organizations or even local chapters, I think from when we look at us as urological oncologists, we need to be the ones really driving that message and really partnering with the community, because I think if we don't get them into our clinic for early screening for early access, we have to have that at the forefront. Would you agree?

Samuel L. Washington III: 100%. And I think even when we do screening events, I look to some of my community partners who are urologists, because I know the majority of the patients, even in our area, are not being seen at UCSF, they're being seen in community practices. So how do we make that a streamlined, smooth process so people aren't falling through the cracks anymore?

Zachary Klaassen: Yeah, absolutely. Always great chatting with you, Sam. Any take home messages, conclusions from our conversation?

Samuel L. Washington III: Yeah, I think I'm grateful to PCF. I'm excited that we can look at this in a granular way and looking forward to see how we develop these partnered interventions.

Zachary Klaassen: Awesome. Thanks so much for joining us, Sam.

Samuel L. Washington III: Yeah.