Racial disparity in breast cancer survivorship: Results of a qualitative research study to identify themes from a series national healthcare provider live virtual forums.

Abstract

12091 Background: Significant disparity exists in the diagnosis, treatment, and survivorship outcomes among Black breast cancer (BC) survivors. Unmet physical and emotional needs in BC survivors are well documented, but there is mounting evidence that Black BC survivors have more significant survivorship issues and a greater burden of illness than White counterparts. Barriers to rehabilitation and recovery care exist for all BC survivors; however, they are magnified in Black BC survivors due to systemic racism, healthcare provider bias and discrimination, lack of culturally relevant care models, and socio-economic barriers. There is limited literature on lived personal and professional experiences of racial disparity in BC survivorship. Methods: The purpose of this qualitative research was to document patient, clinician and researchers’ perceptions surrounding contributing factors, lived experiences, and potential solutions to racial disparity in BC survivorship against the contextual background of reported inequities. A narrative approach was utilized to identify themes from a series of four virtual healthcare provider forums that explored lived personal and professional experiences, issues and potential solutions surrounding racial disparity in BC survivorship from October 2020-September 2021. The forums included perspectives of patients, healthcare providers, researchers, and stakeholders in the BC field. The total live and online views for all four forums was 2,093. An independent thematic analysis was performed by the investigators, all of whom have emic perspectives with respect to race and/or breast cancer. Results: Three main themes were independently identified by study investigators: 1. societal and cultural contributing factors contributing to racial disparity in BC survivorship, 2. contribution of healthcare providers and systems to racial disparity in BC survivorship and 3. models of care and research considerations that would reduce racial disparity. These themes were widely echoed by forum participants throughout the series. With respect to solutions, widespread implementation of navigation models and the Prospective Model of Rehabilitation for Women with Breast Cancer that address physical and psychosocial treatment side effects would reduce disparity. The importance of the inclusion of voices of Black BC survivors in community-based participatory research aimed at reducing survivorship disparity is critical. Conclusions: The findings provide compelling documentation of lived personal and professional experiences of racial disparity in BC survivorship. These issues have been described in the literature for nearly two decades. Potential solutions exist and must be enacted immediately to ensure equitable survivorship outcomes for Black individuals following a BC diagnosis.