JNCI Cancer Spectrum最新文献

{"title":"Socioeconomic determinants of cancer screening adherence among cancer survivors: analysis from the 2020 Behavioral Risk Factor Surveillance System.","authors":"Edoardo Beatrici, Zhiyu Qian, Dejan K Filipas, Benjamin V Stone, Filippo Dagnino, Muhieddine Labban, Stuart R Lipsitz, Giovanni Lughezzani, Nicolò M Buffi, Alexander P Cole, Quoc-Dien Trinh","doi":"10.1093/jncics/pkae127","DOIUrl":"10.1093/jncics/pkae127","url":null,"abstract":"<p><strong>Background: </strong>Factors associated with cancer survivors' preventive health behaviors are understudied. We hypothesized that socioeconomic and health-care access factors may be associated with adherence to recommended cancer screenings.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using the 2020 Behavioral Risk Factor Surveillance System. Cancer survivors eligible for United States Preventive Services Task Force-recommended breast, cervical, prostate, and colorectal screenings were included. Multivariable logistic regression models were used to identify socioeconomic factors significantly associated with screening adherence.</p><p><strong>Results: </strong>Overall, 64 958 (weighted national estimate = 29 066 143) cancer survivors were included. Adherence rates varied across cancer types: 80.9% for breast, 88.9% for cervical, 54.1% for prostate, and 84.7% for colorectal cancer. Key predictors of low adherence included lower income (breast: adjusted odds ratio [aOR] = 0.56, 95% confidence interval [CI] = 0.43 to 0.74; cervical: aOR = 0.38, 95% CI = 0.24 to 0.59; prostate: aOR = 0.36, 95% CI = 0.24 to 0.52; colorectal: aOR = 0.74, 95% CI = 0.57 to 0.96), lack of health-care coverage for colorectal cancer (aOR = 0.51, 95% CI = 0.36 to 0.73), time since last checkup between 1 and 2 years prior for breast (aOR = 0.58, 95% CI = 0.45 to 0.75), prostate (aOR = 0.66, 95% CI = 0.47 to 0.91), and colorectal (aOR = 0.69, 95% CI = 0.56 to 0.86) cancer, and no health-care provider for breast (aOR = 0.68, 95% CI = 0.47 to 0.98), prostate (aOR = 0.45, 95% CI = 0.31 to 0.65), and colorectal (aOR = 0.51, 95% CI = 0.40 to 0.66) cancer.</p><p><strong>Conclusion: </strong>Cancer survivors' adherence to screening is associated with factors including lack of health-care coverage, lower income, time since the last exam, and having a personal provider. Targeted interventions accounting for such factors may help mitigate these disparities.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for a cancer exposome atlas: a scoping review.","authors":"Anna S Young, Catherine E Mullins, Neha Sehgal, Roel C H Vermeulen, P Martijn Kolijn, Jelle Vlaanderen, Mohammad L Rahman, Brenda M Birmann, Dinesh Barupal, Qing Lan, Nathaniel Rothman, Douglas I Walker","doi":"10.1093/jncics/pkae122","DOIUrl":"10.1093/jncics/pkae122","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in understanding genetic susceptibility to cancer, much of cancer heritability remains unidentified. At the same time, the makeup of industrial chemicals in our environment only grows more complex. This gap in knowledge on cancer risk has prompted calls to expand cancer research to the comprehensive, discovery-based study of nongenetic environmental influences, conceptualized as the \"exposome.\"</p><p><strong>Methods: </strong>Our scoping review aimed to describe the exposome and its application to cancer epidemiology and to study design limitations, challenges in analytical methods, and major unmet opportunities in advanced exposome profiling methods that allow the quantification of complex chemical exposure profiles in biological matrices. To evaluate progress on incorporating measurements of the exposome into cancer research, we performed a review of such \"cancer exposome\" studies published through August 2023.</p><p><strong>Results: </strong>We found that only 1 study leveraged untargeted chemical profiling of the exposome as a method to measure tens of thousands of environmental chemicals and identify prospective associations with future cancer risk. The other 13 studies used hypothesis-driven exposome approaches that targeted a set of preselected lifestyle, occupational, air quality, social determinant, or other external risk factors. Many of the included studies could only leverage sample sizes with less than 400 cancer cases (67% of nonecologic studies) and exposures experienced after diagnosis (29% of studies). Six cancer types were covered, most commonly blood (43%), lung (21%), or breast (14%) cancer.</p><p><strong>Conclusion: </strong>The exposome is underutilized in cancer research, despite its potential to unravel complex relationships between environmental exposures and cancer and to inform primary prevention.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Braillon.","authors":"Kaitlin Chakos, Lisa Tussing-Humphreys, Kelsey Gabel","doi":"10.1093/jncics/pkae126","DOIUrl":"10.1093/jncics/pkae126","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity and incident cardiovascular disease in breast cancer survivors: the Pathways Study.","authors":"Jacob K Kresovich, Alicia R Richards, Isaac J Ergas, Rikki Cannioto, Catherine Thomsen, Cecile A Laurent, Salma Shariff-Marco, Eileen Rillamas-Sun, Tatjana Kolevska, Song Yao, Christine Ambrosone, Lawrence Kushi, Heather Greenlee, Marilyn L Kwan","doi":"10.1093/jncics/pkae123","DOIUrl":"10.1093/jncics/pkae123","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer survivors experience higher rates of cardiovascular disease (CVD) than women without breast cancer, due in part to cardiotoxic cancer treatments and shared lifestyle risk factors. Physical activity is associated with lower mortality risk in breast cancer survivors, but associations with CVD have not been examined in detail.</p><p><strong>Methods: </strong>The Pathways Study is a prospective cohort study of 4504 women diagnosed with invasive breast cancer between 2005 and 2013. At enrollment, women self-reported their physical activities during the previous 6 months, which were dichotomized as meeting the Centers for Disease Control and Prevention's Physical Activity Guidelines for Americans (≥150 minutes of moderate-intensity or ≥75 minutes of vigorous-intensity activity per week) vs not. Incident CVD events (heart failure, cardiomyopathy, cardiac arrest, ischemic heart disease, stroke) occurring between enrollment and December 2021 were identified from electronic health records. Covariate-adjusted, competing-risks Cox regression models estimated associations between meeting physical activity guidelines and CVD risk.</p><p><strong>Results: </strong>Compared with women who did not meet physical activity guidelines at their diagnosis, those who did had a 25% lower risk of CVD (HR = 0.75, 95% CI = 0.60 to 0.94). Among the individual CVD outcomes, meeting physical activity guidelines was protective against incident cardiomyopathy (hazard ratio [HR] = 0.54, 95% CI = 0.31 to 0.95), heart failure (HR = 0.66, 95% CI = 0.50 to 0.87), and cardiac arrest (HR = 0.68, 95% CI = 0.49 to 0.99).</p><p><strong>Conclusions: </strong>Meeting physical activity guidelines at breast cancer diagnosis was associated with lower risk of CVD after diagnosis. Studies investigating changes in physical activity after a breast cancer diagnosis and CVD risk are warranted.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Breast Cancer Risk Associated with Benign Breast Disease from 1967 to 2013.","authors":"Amy C Degnim, Karthik Ghosh, Robert A Vierkant, Stacey J Winham, Tanya L Hoskin, Jodi M Carter, Bryan M Mccauley, Matt R Jensen, Teresa Allers, Marlene Frost, Denice L Gehling, Jessica L Fischer, Lisa R Seymour, Laura M Pacheco-Spann, Philip S Rosenberg, Lori A Denison, Celine M Vachon, Lynn C Hartmann, Derek C Radisky, Mark E Sherman","doi":"10.1093/jncics/pkae128","DOIUrl":"https://doi.org/10.1093/jncics/pkae128","url":null,"abstract":"<p><strong>Background: </strong>Benign breast disease (BBD) increases breast cancer (BC) risk progressively for women diagnosed with non-proliferative (NP) change, proliferative disease without atypia (PDWA), and atypical hyperplasia (AH). Leveraging data from 18,704 women in the Mayo BBD Cohort (1967-2013), we evaluated temporal trends in BBD diagnoses and how they have influenced associated BC risk over four decades.</p><p><strong>Methods: </strong>BC risk trends associated with BBD were evaluated using standardized incidence ratios (SIRs) and age-period-cohort modeling across four eras-pre-mammogram (1967-1981), pre-core needle biopsy (CNB) (1982-1992), transition to CNB (1993-2001), and CNB era (2002-2013).</p><p><strong>Results: </strong>With a median follow-up of 15.8 years, 9.9% of women were diagnosed with BC (invasive and/or DCIS). From the pre-mammogram era to the CNB era, we observed a significant increase in BC risk, rising from an SIR of 1.61 to 1.99. The proportion of proliferative BBD diagnoses (PDWA or AH) increased markedly over time (28.1% to 49.7%), as did the proportion of DCIS events (11% to 28%; chi-square p < .001). Within specific BBD categories, the risk of invasive BC increased modestly.</p><p><strong>Conclusions: </strong>While absolute risk of BC within BBD categories remained stable, the relative risk of BC after BBD increased over time due to notable increases in higher risk BBD lesions, specifically PDWA and AH. These findings illustrate how evolving screening practices have changed the risk profile of BBD and should inform management strategies for patients with BBD in modern clinical settings.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer outcomes and cardiopulmonary toxicities for black patients with breast cancer treated with proton therapy.","authors":"Gurbani Singh, Sravya Koduri, Manaahil Rao, Meira Kidorf, Sarah Ruff, Akshar Patel, Søren M Bentzen, Elizabeth Nichols, Sarah Mcavoy, Melissa A Vyfhuis","doi":"10.1093/jncics/pkae129","DOIUrl":"https://doi.org/10.1093/jncics/pkae129","url":null,"abstract":"<p><strong>Background: </strong>Black women have a 40% higher breast cancer (BC) mortality rate than White women and are at a higher risk of acquiring cardiovascular disease. Proton therapy (PT) can be used to mitigate cardiac radiation exposure; however, PT remains a scarce resource in the United States. We report on the cardiovascular profiles of patients undergoing PT to determine the potential benefit of PT for Black women when compared to non-Black patients.</p><p><strong>Methods: </strong>We retrospectively analyzed 599 BC patients who received PT from June 2016 to December 2021 at the Maryland Proton Treatment Center. A variety of sociodemographic, disease, and treatment variables were analyzed using descriptive statistics.</p><p><strong>Results: </strong>With a median follow-up of 26 months (range: 0.47-90 months), Black patients comprised 31.6% of the population and presented with higher rates of hypertension (p < .001), cardiopulmonary conditions (p < .001), and a larger median BMI (p = .015) when compared to the other cohort, a trend that persisted at time of post-PT follow-up. Black women had higher rates of triple negative disease (p < .001) with subsequent greater receipt of neoadjuvant chemotherapy (p = .039). Pulmonary events were 2.6-times more likely to occur in Black patients vs the non-Black cohort after PT (OR : 2.60; CI: 1.39-4.88; p = .003).</p><p><strong>Conclusions: </strong>Black women presenting for PT had higher baseline risks of cardiovascular co-morbidities combined with more aggressive BC biology and a subsequent 2.6-fold increased risk of pulmonary events after PT. Our findings support the use of advanced radiation techniques as means to spare important organs-at-risk, especially in historically marginalized populations.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the intersection of climate vulnerability and cancer burden in North Carolina.","authors":"Joyce Pak, Ngan Le, Eman M Metwally, Jeanny Wang, Arrianna Marie Planey, Amy M Lowman, Bradford E Jackson, Eboneé N Butler, Jennifer L Lund","doi":"10.1093/jncics/pkae124","DOIUrl":"https://doi.org/10.1093/jncics/pkae124","url":null,"abstract":"<p><p>Climate-related extreme weather events disrupt healthcare systems and exacerbate health disparities, particularly affecting individuals diagnosed with cancer. This study explores the intersection of climate vulnerability and cancer burden in North Carolina (NC). Using county-level data from the US Climate Vulnerability Index (CVI) and the NC Department of Health and Human Services, we analyzed cancer incidence and mortality rates from 2017-2021. Our findings reveal a robust correlation between CVI percentiles and cancer mortality (r = 0.72). Counties with high area deprivation like Scotland, Robeson, and Halifax had the highest CVI percentiles of 0.68, 0.67, and 0.66, with respective cancer mortality rates of 193, 195, and 196 per 100,000 person-years. Correlations between CVI and cancer incidence were modest (r = 0.22). These results underscore the need for targeted public health interventions to mitigate climate-related health disparities. Future work could focus on exploring specific climate hazards and cancer outcomes to enhance preparedness and resilience in cancer care.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving real-world evaluation of patient- and physician-reported tolerability: niraparib for recurrent ovarian cancer (NiQoLe).","authors":"Florence Joly, Fernando Bazan, Delphine Garbay Decoopman, Yaelle Ouldbey, Philippe Follana, Élise Champeaux-Orange, Eric Legouffe, Pierre-Emmanuel Brachet, Dominique Spaeth, Pierre Combe, Anne-Claire Hardy-Bessard, Frédéric Selle, Julien Grenier, Coriolan Lebreton, Olfa Derbel, Elise Bonnet, Pierre Fournel, Yolanda Fernandez Diez, Valérie Delecroix, Sheik Emambux, Jérôme Alexandre, Thomas Grellety, Dominique Mille, Hubert Orfeuvre, Catherine Favier, Delphine Le Roux, Marie-Ange Mouret-Reynier, Stanislas Quesada, Jean-Emmanuel Kurtz","doi":"10.1093/jncics/pkae114","DOIUrl":"https://doi.org/10.1093/jncics/pkae114","url":null,"abstract":"<p><strong>Background: </strong>Maintenance niraparib at an individualized starting dose (ISD) is established in platinum-sensitive recurrent ovarian cancer (PSROC). However, patients' perspectives on the burden of prolonged maintenance therapy have not been reported in prospective trials or routine practice.</p><p><strong>Methods: </strong>In the real-life multicenter NiQoLe study, patients with PSROC received ISD maintenance niraparib. The primary objective was to describe physician-reported adverse events (AEs) leading to treatment modification during the first 3 months. Secondary endpoints included patient-reported outcomes (symptomatic AEs using PRO-CTCAE, self-reported fatigue and impact on daily activities/function using FACT-F) collected remotely weekly using a specifically designed electronic device.</p><p><strong>Results: </strong>Most (80%) of 139 treated patients (median age 70 years) began niraparib at 200 mg/day. Median treatment duration was 5.7 (range 0.2-21.4) months. During the first 3 months, 86 patients (62%) required treatment modification (median 27 days to modification). Physician-reported grade ≥3 niraparib-related AEs occurred in 34 patients (24%); 68 patients (49%) had treatment modification for AEs, predominantly thrombocytopenia. The most frequent patient-reported AEs (PRO-CTCAE) were fatigue, insomnia, constipation, and dry mouth. Self-reported AEs were severe in 66% of patients. At baseline, 33% of patients reported severe fatigue (FACT-F), which generally persisted during niraparib. Physicians systematically underestimated major patient-reported symptoms.</p><p><strong>Conclusions: </strong>In routine practice, dose modification was often required during the first 3 months despite individualized dosing. Physicians underestimated the burden of fatigue and symptomatic AEs. Digital self-reporting of AEs is feasible, provides patient-centered information complementing physician-reported AEs, and allows fuller appreciation of toxicity in real-world studies.</p><p><strong>Clinical trial information: </strong>NCT03752216.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social determinants of health and variability in treatment for patients with early-stage Non-Small Cell Lung Cancer.","authors":"Molly Scannell Bryan, Xiaohan Hu, Monika A Izano, Hina Mohammed, Marianna Wicks, Thomas Brown, George Simon, Henry Kaplan, Anna Berry","doi":"10.1093/jncics/pkae117","DOIUrl":"https://doi.org/10.1093/jncics/pkae117","url":null,"abstract":"<p><strong>Background: </strong>In non-small cell lung cancer (NSCLC), social determinants of health (SDOHs) influence treatment, but SDOHs with geographic precision are infrequently used in real-world research due to privacy considerations. This research aims to characterize the influence of census-tract level SDOHs on treatment for stage I and IIa NSCLC.</p><p><strong>Methods: </strong>Patients diagnosed between 1/1/17 and 9/30/22 with stages I and IIa NSCLC in the Syapse Learning Health Network had their addresses geocoded and linked to five census tract-level indicators of SDOH (social vulnerability index (SVI), percent (%) housing burden, % broadband internet access, primary care shortage area, and rurality). Clinical and demographic characteristics were ascertained from medical records. Nested multinomial logistic regression models estimated associations between SDOHs and initial treatment using two-sided Wald tests. The collective statistical significance of SDOHs was assessed with a likelihood ratio test (LRT) comparing nested models. Descriptive statistics described time-to-treatment-initiation.</p><p><strong>Results: </strong>Among 3595 patients, 58% were initially treated with surgery, 29% with radiation, and 12% with \"other.\" Two SDOH variables were associated with increased relative risk ratios (RRR) for radiation therapy compared to surgery: living in primary care shortage areas (RRR 1.61, 95% CI: (1.23-2.10)) and living in non-metropolitan areas (RRR 1.45 (1.02-2.07)). The LRT suggested that the five SDOH variables collectively improved the treatment model. Further, patients in areas with high SVI, low internet access, and high housing-burden initiated treatment later.</p><p><strong>Conclusion: </strong>When using precise estimates of geospatial SDOHs, these measures were associated with treatment, and should be considered in analyses of cancer outcomes.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer Clinical Trial Participation: A Qualitative Study of Black/African American Communities' and Patient/Survivors' Recommendations.","authors":"Linda Kaljee, Sylvester Antwi, Doreen Dankerlui, Donna Harris, Barbara Israel, Denise White-Perkins, Valerie Ofori Aboah, Livingstone Aduse-Poku, Harriet Larrious-Lartey, Barbara Brush, Chris Coombe, La'Toshia Patman, Nayomi Cawthorne, Sophia Chue, Zachary Rowe, Cassandra Mills, Kurt Fernando, Gwendolyn Daniels, Eleanor M Walker, Evelyn Jiagge","doi":"10.1093/jncics/pkae119","DOIUrl":"https://doi.org/10.1093/jncics/pkae119","url":null,"abstract":"<p><strong>Background: </strong>Black/African Americans experience a disproportionate cancer burden and mortality rates. Racial/ethnic variation in cancer burden reflects systemic and healthcare inequities, cancer risk factors, and heredity and genomic diversity. Multiple systemic, socio-cultural, economic, and individual factors also contribute to disproportionately low Black/African American participation in cancer clinical trials.</p><p><strong>Methods: </strong>The Participatory Action for Access to Clinical Trials project utilized a community-based participatory research (CBPR) approach inclusive of Black/African American community-based organizations (CBOs), Henry Ford Health (HFH), and the University of Michigan Urban Research Center. The project aims were to understand Black/African Americans' behavioral intentions to participate in cancer clinical trials and to obtain recommendations for improving participation. Audio-recorded focus group data were transcribed, coded, and searches were conducted to identify themes and subthemes. Representative text was extracted from the transcripts.</p><p><strong>Results: </strong>Six community focus group discussions (70 participants) and six HFH patient/survivor focus group discussions (29 participants) were completed. General themes related to trial participation were identified including: 1) systemic issues related to racism, health disparities, and trust in government, health systems, and clinical research; 2) firsthand experiences with healthcare and health systems; 3) perceived and experienced advantages and disadvantages of clinical trial participation; and 4) recruitment procedures and personal decision-making processes. Specific recommendations on how to address barriers were obtained.</p><p><strong>Conclusions: </strong>CBPR is effective in bringing communities equitably to the table. To build trust, health systems must provide opportunities for patients and communities to jointly identify factors affecting cancer clinical trial participation, implement recommendations, and address health disparities.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}