Oncologists’ perceptions of tumor genomic profiling and barriers to communicating secondary hereditary risks to African American cancer patients
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 mis...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-04-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-024-12184-y |
| _version_ | 1797219762483232768 |
|---|---|
| author | Michael J. Hall Paul A. D’Avanzo Yana Chertock Patrick J. A. Kelly Jesse Brajuha Katie Singley Caseem C. Luck Sarah B. Bass |
| author_facet | Michael J. Hall Paul A. D’Avanzo Yana Chertock Patrick J. A. Kelly Jesse Brajuha Katie Singley Caseem C. Luck Sarah B. Bass |
| author_sort | Michael J. Hall |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-24T12:38:48Z |
| format | Article |
| id | doaj.art-d20acf8b9e0942a1bd7b8d791cc3c7c4 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-24T12:38:48Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-d20acf8b9e0942a1bd7b8d791cc3c7c42024-04-07T11:21:36ZengBMCBMC Cancer1471-24072024-04-0124111110.1186/s12885-024-12184-yOncologists’ perceptions of tumor genomic profiling and barriers to communicating secondary hereditary risks to African American cancer patientsMichael J. Hall0Paul A. D’Avanzo1Yana Chertock2Patrick J. A. Kelly3Jesse Brajuha4Katie Singley5Caseem C. Luck6Sarah B. Bass7Department of Clinical Genetics, Fox Chase Cancer CenterCollege of Public Health, Department of Social and Behavioral Sciences, Temple UniversityDepartment of Clinical Genetics, Fox Chase Cancer CenterCollege of Public Health, Department of Social and Behavioral Sciences, Temple UniversityCollege of Public Health, Department of Social and Behavioral Sciences, Temple UniversityCollege of Public Health, Department of Social and Behavioral Sciences, Temple UniversityCollege of Public Health, Department of Social and Behavioral Sciences, Temple UniversityCollege of Public Health, Department of Social and Behavioral Sciences, Temple UniversityAbstract 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.https://doi.org/10.1186/s12885-024-12184-yOncologyTumor genomic profilingAfrican American populationGenetic testingHealth disparitiesHereditary cancer risk |
| spellingShingle | Michael J. Hall Paul A. D’Avanzo Yana Chertock Patrick J. A. Kelly Jesse Brajuha Katie Singley Caseem C. Luck Sarah B. Bass Oncologists’ perceptions of tumor genomic profiling and barriers to communicating secondary hereditary risks to African American cancer patients BMC Cancer Oncology Tumor genomic profiling African American population Genetic testing Health disparities Hereditary cancer risk |
| title | Oncologists’ perceptions of tumor genomic profiling and barriers to communicating secondary hereditary risks to African American cancer patients |
| title_full | Oncologists’ perceptions of tumor genomic profiling and barriers to communicating secondary hereditary risks to African American cancer patients |
| title_fullStr | Oncologists’ perceptions of tumor genomic profiling and barriers to communicating secondary hereditary risks to African American cancer patients |
| title_full_unstemmed | Oncologists’ perceptions of tumor genomic profiling and barriers to communicating secondary hereditary risks to African American cancer patients |
| title_short | Oncologists’ perceptions of tumor genomic profiling and barriers to communicating secondary hereditary risks to African American cancer patients |
| title_sort | oncologists perceptions of tumor genomic profiling and barriers to communicating secondary hereditary risks to african american cancer patients |
| topic | Oncology Tumor genomic profiling African American population Genetic testing Health disparities Hereditary cancer risk |
| url | https://doi.org/10.1186/s12885-024-12184-y |
| work_keys_str_mv | AT michaeljhall oncologistsperceptionsoftumorgenomicprofilingandbarrierstocommunicatingsecondaryhereditaryriskstoafricanamericancancerpatients AT pauladavanzo oncologistsperceptionsoftumorgenomicprofilingandbarrierstocommunicatingsecondaryhereditaryriskstoafricanamericancancerpatients AT yanachertock oncologistsperceptionsoftumorgenomicprofilingandbarrierstocommunicatingsecondaryhereditaryriskstoafricanamericancancerpatients AT patrickjakelly oncologistsperceptionsoftumorgenomicprofilingandbarrierstocommunicatingsecondaryhereditaryriskstoafricanamericancancerpatients AT jessebrajuha oncologistsperceptionsoftumorgenomicprofilingandbarrierstocommunicatingsecondaryhereditaryriskstoafricanamericancancerpatients AT katiesingley oncologistsperceptionsoftumorgenomicprofilingandbarrierstocommunicatingsecondaryhereditaryriskstoafricanamericancancerpatients AT caseemcluck oncologistsperceptionsoftumorgenomicprofilingandbarrierstocommunicatingsecondaryhereditaryriskstoafricanamericancancerpatients AT sarahbbass oncologistsperceptionsoftumorgenomicprofilingandbarrierstocommunicatingsecondaryhereditaryriskstoafricanamericancancerpatients |