Early Cancer Screening Impressions of African-American Breast Cancer Patients Enrolled on the Navigator-Assisted Hypofractionation (NAVAH) Trial.

Abstract

Objectives: African-Americans have the highest cancer mortality rates and the lowest survival rates compared with other racial groups in the US. The Navigator-Assisted Hypofractionation (NAVAH) program includes a culturally sensitive survey to assess the impact of patient navigation on access to hypofractionated radiation therapy (RT) for African-American breast cancer patients. This study reports cancer screening impressions of participants enrolled in the ongoing NAVAH phase I clinical trial, marking a significant first in this field.

Methods: After a referral for RT from a multidisciplinary tumor board, trial-eligible patients were invited to participate in the NAVAH trial. Surveys were administered before RT to assess overall cancer screening knowledge, categorizing responses as outstanding (18 to 23 points), excellent (24 to 29 points), good (30 to 35 points), average (36 to 42 points), or below average (>43 points). Knowledge was further stratified through 3 specific criteria: early screening, prognosis, and toxicity awareness with responses categorized as excellent, good, or average for each domain. Correlations between education levels and responses were analyzed using variance analysis (P<0.05).

Results: An initial cohort of 35 trial participants was assessed. The average cancer screening and treatment knowledge score was 27.6. Participants showed excellent understanding of early screening and prognosis and good knowledge of toxicity. There was no significant correlation between educational attainment and cancer knowledge or income levels. This ongoing phase I clinical trial highlights a relative deficiency in toxicity knowledge compared with prognosis and early screening.

Conclusions: Early impressions indicate that African-American breast cancer patients have an overall excellent knowledge of cancer screening and treatment, not correlated with socioeconomic or educational status, except treatment toxicity knowledge. Future education initiatives should focus on treatment toxicity to optimize patient awareness before adjuvant breast cancer RT.