Opportunities for precision medicine: Factors associated with participation in genetic research among breast cancer survivors.

Abstract

94 Background: Finding unique cancer therapies based on the specific genomic profiles of a person’s tumor is a national priority. Precision medicine can reduce disparate outcomes – particularly among Black breast cancer survivors who have higher mortality rates. Black women tend to be underrepresented in genomic research. Methods: Hormone receptive positive breast cancer survivors (Whites = 334, Blacks = 124, Other = 23) were recruited via hospitals and outreach. Data were collected via telephone interviews to assess sociocultural and health care processes; clinical data were abstracted from charts. Cell pellets were harvested from mouthwashes by centrifugation, followed by washing with PBS solution twice. After the baseline, women had a brief telephone information session. Low literacy materials explaining biospecimen collection were mailed. The primary outcome was receipt of the biospecimen sample in three months. Logistic regression assessed factors associated with biospecimens receipt. Results: Most (69%) survivors provided biospecimens. Most (92.8%) samples had good size cell pellets. Most (93%) of the mouth wash samples will have sufficient DNA for genotyping assays. In bivariate analysis, race, education, and mistrust were not associated with biospecimen receipt (p> .05). Survivors more likely to provide biospecimens had higher ratings of: confidence in physicians’ technical skills, communication with providers, satisfaction with time with providers, and overall satisfaction with care (p< .05). Health literacy and functional well-being were also associated with biospecimen receipt. In multivariate models, only survivor’s ratings of their level of confidence in her oncologists’ technical skills remained significant (OR: 1.6 per 1 point increase; CI: 1.1, 2.5). Conclusions: Regardless of race, most breast cancer survivors are willing to provide biospecimens for genomics research. Brief informational sessions and simple low-literacy materials may enhance participation. Relationships with oncologists are salient to promoting survivors participation in genomics research.