Oncologists’ perceptions of tumor genomic profiling and barriers to communicating secondary hereditary risks to African American cancer patients

Michael J. Hall, Paul A. D’Avanzo, Yana Chertock, Patrick J.A. Kelly, Jesse Brajuha, Katie Singley, Caseem C. Luck, Sarah B. Bass

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Tumor genomic profiling (TGP) identifies targets for precision cancer treatments, but also secondary hereditary risks. Oncologists are poorly trained to communicate the results of TGP, especially among patients with lower health literacy, poorer genetics knowledge, and higher mistrust. African American (AA) patients are especially vulnerable to poor understanding due to significant cancer disparities and lower uptake of TGP. The goal of this research is to inform the development of an internet-based brief educational support for oncologists to prepare them to provide better decisional support related to TGP for their AA cancer patients. Methods: This mixed-methods study used semi-structured interviews of oncologists to inform development of an online survey with a convenience sample of US-based oncologists (n = 50) to assess perceptions of the challenges of TGP and communicating results to AA patients. Results: Most interviewed oncologists felt it was important to consider racial/cultural differences when communicating about hereditary risks. Cost, family dynamics, discrimination concerns, and medical mistrust were identified as particularly salient. Survey respondents’ views related to AAs and perceptions of TGP were strongly associated with years since completing training, with recent graduates expressing stronger agreement with statements identifying barriers/disadvantages to TGP for AA patients. Conclusions: Oncologists who had more recently completed training expressed more negative perceptions of TGP and more perceived challenges in communicating about TGP with their AA patients. Focused training for oncologists that addresses barriers specific to AAs may be helpful in supporting improved communication about TGP and improved decisional support for AA patients with cancer considering TGP to evaluate their tumors.

Original languageEnglish
Article number412
Pages (from-to)412
JournalBmc Cancer
Volume24
Issue number1
DOIs
StatePublished - Mar 2 2024

Keywords

  • African American population
  • Barriers to healthcare
  • Cancer burden
  • Genetic testing
  • Health disparities
  • Health literacy
  • Hereditary cancer risk
  • Oncology
  • Tumor genomic profiling
  • Oncologists
  • Humans
  • Genomics
  • Risk Factors
  • Physician-Patient Relations
  • Neoplasms/genetics
  • Trust
  • Black or African American/genetics
  • Communication

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