Abstract IA41: Emerging Issues in Cancer Screening for Racial and Ethnic Minorities

Abstract

Abstract Cancer screening plays an important role in early detection; detecting cancer in an early stage has important implications for cancer health disparities. Considerable efforts have been made to increase access to early detection services among racial and ethnic minorities in order to improve cancer outcomes in these populations. However, our recent work has shown that racial disparities in cancer screening continue to exist. For instance, about 40% of women in our national random survey of cultural considerations in cancer screening were not up-to-date with mammography guidelines. Our other work with a community-based sample of African American men demonstrated that informed decision-making about PSA testing may be low. Fifty-seven percent of men reported having a PSA test during the past year, but none of the variables that are important to informed decision-making were associated with having annual screening. With respect to lung cancer screening, our recent qualitative research demonstrated that patients have limited discussions with providers about the benefits and limitations of lung cancer screening and had difficulty recalling receipt of information about screening, even though many decided to have low dose computed tomography (LDCT). This may be because of limited knowledge about screening guidelines and low enthusiasm and commitment to LCDT among providers. Providers relied on clinical reminders from the electronic health system to remind them to assess patients for eligibility for LDCT and offer screening. Provider referral to smoking cessation programs was also limited. Provider referral to smoking cessation programs, and delivery of this service, is especially important among high-risk smokers who are candidates for LCDT. Using data from the National Lung Screening Trial (NLST), our research demonstrated that current smokers have an increased risk of lung cancer and all-cause mortality compared to former smokers regardless of randomization to LCDT or the control condition. In addition, smoking abstinence for seven years was associated with a 20% reduction in lung cancer mortality among those screened with chest radiograph. Screening with LCDT and smoking abstinence for 15 years had the greatest mortality risk reduction. African Americans were under-represented in the NLST; therefore, greater efforts are needed to disseminate and implement lung cancer screening in more diverse health care facilities. Citation Format: Chanita Hughes Halbert. Emerging Issues in Cancer Screening for Racial and Ethnic Minorities. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr IA41.