Amplifying Their Voices: Advice, Guidance, and Perceived Value of Cancer Biobanking Research Among an Older, Diverse Cohort

The use of biobanks may accelerate scientists' chances of developing cures and treatments that are tailored to individuals' biological makeup-a function of the precision medicine movement. However, given the underrepresentation of certain populations in biobanks, the benefits of these resources may not be equitable for all groups, including older, multi-ethnic populations. The objective of this study was to better understand older, multi-ethnic populations' (1) perceptions of the value of cancer biobanking research, (2) study design preferences, and (3) guidance on ways to promote and increase participation. This study was designed using a community-based participatory research (CBPR) approach and involved eight FGDs with 67 older (65-74 years old) black and white residents from Baltimore City and Prince George's County, MD. FGDs lasted between 90 and 120 min, and participants received a $25 Target gift card for their participation. Analysis involved an inductive approach in which we went through a series of open and axial coding techniques to generate themes and subthemes. Multiple themes emerged from the FGDs for the development of future cancer-related biobanking research including (1) expectations/anticipated benefits, (2) biobanking design preferences, and (3) ways to optimize participation. Overall, most participants were willing to provide biospecimens and favored cancer-related biobank. To increase participation of older, diverse participants in biobanking protocols, researchers need to engage older, diverse persons as consultants in order to better understand the value of biobanking research to individuals from the various populations. Scientists should also incorporate suggestions from the community on garnering trust and increasing comfort with study design.

Abstract PO-195: Methodology for characterizing clinical differences & disparities for global populations to support disease area prioritization in industry oncology clinical development programs: Insights to inform scientifically driven evidence generation

Introduction Population-specific disparities in clinical research are well characterized-with individuals of European ancestry comprising the majority of genetic and clinical data globally. Disease course and treatment response can vary across individuals of different race/ethnicity and ancestral backgrounds. As the population continues to diversify and healthcare evolves toward personalized medicine, it's essential that the biological differences among populations, and how these affect disease pathology, experience and outcomes, are investigated early and throughout the development process. Currently, there is no defined standard for characterizing population differences across diseases. Establishing a methodology to systematically assess and consider medically relevant population specific attributes for understudied populations is a critical enabler for the clinical research enterprise and supports greater inclusive clinical research. We established a methodology to assess and prioritize population specific attributes across disease areas (DA) and a framework to support hypothesis generation and population-driven clinical development considerations. Methods Data sources: NCI SEER, WHO Global Cancer Observatory, Global Health Data Exchange Burden of Disease, and published literature were used to assess population specific differences Attributes included: 1) Incidence and prevalence 2) Clinical outcomes, 3) molecular drivers, and 4) access factors. Population elements of race/ethnicity, genomic ancestry, and geographic origin were used to stratify outputs. A grid ranking framework was established based on relative prevalence and incidence and level of concordance or distinction of the above attributes across populations. Summary Methodology was established that included identification and analysis of key population-specific factors to rank DA's within a grid system. The following diseases were characterized as having disproportionate prevalence as well as biologically plausible population specific differences. Breast Cancer Cervical Cancer Colorectal Cancer Gastric Cancer Hepatocellular Carcinoma Head & Neck SCC Multiple Myeloma NSCLC Prostate Cancer Population specific reports were developed and used to inform business integration process into evidence generation considerations including guidelines for assessments of population level pertinence to study hypothesis, response modification potential, and relevance of biomarker differences. Conclusion The established methodology and framework provides a process and standards to characterize biologically relevant population specific attributes for understudied global populations at the disease level. This approach will support the clinical development environment to systematically approach conduct of scientifically driven inclusion of representative patients in research, ultimately supporting greater inclusion of understudied patient populations.

Citation Format: Keith Dawson, Dane Callow, Jimmy Ngueyn, Altovise T. Ewing, Ruma Bhagat, William Boyd, Caroline McCammond, Nicole Richie. Methodology for characterizing clinical differences & disparities for global populations to support disease area prioritization in industry oncology clinical development programs: Insights to inform scientifically driven evidence generation [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-195.

Factors associated with willingness to provide biospecimens for genetics research among African American cancer survivors

This study evaluated factors associated with willingness to provide biospecimens for cancer genetic research among African American cancer survivors. A total of 200 African American adults diagnosed with breast, colon, and/or prostate cancers completed a self-administered survey. Family history information, beliefs about cancer research, cancer genetics and disparities knowledge, willingness to provide a biospecimen, and demographics were obtained. Chi-square, independent samples t tests, and logistic regression analyses were performed. Overall, 79% of this sample was willing to provide a biospecimen for cancer genetics research. Independent associations of willingness to provide a biospecimen existed among demographics (males (p = 0.041)), those who believed in the importance of genetic causes of cancer (p < 0.001), individuals who believe it is important to participate in genetics research (p < 0.001), and those who indicated they would participate in genetics research to help future generations (p = 0.026). Overall, 12.5-56% of participants demonstrated some level of genetics and cancer disparities. This study identified factors that may be incorporated into future research interventions to engage the African American cancer population in cancer genetics biobanking research.

Beliefs and Preferences for Medical Research Among African-Americans

BACKGROUND AND OBJECTIVES

Numerous factors contribute to underrepresentation of African-Americans in medical research, including beliefs, historical events, structural, and health access obstacles. This study examined beliefs about medical research and the types of study methods preferred among potential African-American research participants.

METHODS

A sample of 304 African-American participants from the Washington, DC Metropolitan area, completed a survey evaluating beliefs about medical research and preferred research study methods. Multiple Regression analyses were performed to examine how age, gender, and education may influence these beliefs and preferences for research study methods.

RESULTS

The beliefs and preferences surveyed did not differ by age, gender, or educational attainment. There was an overwhelmingly favorable belief (90 %) that medical research was necessary and assists in finding a cure for a disease. Most respondents preferred participating in research related to issues with which they were familiar (e.g., diabetes, hypertension) or working with researchers of a similar ethnic background to themselves. Interestingly, though nonsignificant, those with higher levels of educational trended toward the belief that participation in research was risky.

CONCLUSION

The findings of this study indicate that certain beliefs about medical research participation and preferred study methodologies reported by African-Americans did not differ by age, gender, or level of education. This information about African-American's beliefs and preferences regarding medical research should lead to an awareness of potential gains in African-American participation through the development of culturally sensitive medical research studies and methodologies.

Demographic differences in willingness to provide broad and narrow consent for biobank research

PURPOSE

This study examined acceptability of two biobank consent models and evaluated the impact of beliefs about privacy and genetic safeguards on acceptance.

METHODS

U.S. adults surveyed online in English and Spanish were randomly assigned to one of two scenarios examining acceptance of broad consent (n=1528), or narrow consent (n=1533).

RESULTS

Overall, willingness to provide broad (76%) and narrow (74%) consents were similar. African Americans were as likely as white non-Hispanics to accept narrow consent (72% vs. 77%, p=0.35) but significantly less likely to accept broad consent (69% vs. 81%, p=0.004). Education, insurance, and blood donation history were also related to acceptance. Adjusting for beliefs about privacy and policy protections (Genetic Information Nondiscrimination Act, GINA), the effects of the variables were reduced. Respondents who drew comfort from GINA were more likely to support both consent (both p<0.001); those who believed it is impossible to maintain privacy were less likely to find both broad (p=0.04) and narrow models acceptable (p=0.02).

CONCLUSIONS

Choice of consent model matters when engaging diverse populations in biobank research. Beliefs underlying concerns about privacy and genetic protections should be considered when constructing biobank protocols.

Abstract 1355: Biospecimen preferences of African-American cancer survivors for cancer genetic research

Background: Research based on large population-based biobanks has potential to ameliorate health disparities attributed to biological and genetic differences. Study goals were to identify associations of cancer survivors’ sample preferences with sociodemographic characteristics and familiarity with genetic research and testing.

Methods: Information was analyzed on a convenience sample of 158 adult African-American breast, colon or prostate cancer survivors who expressed a willingness to provide a biospecimen for cancer genetic research. Information was collected from a self-directed instrument that measured: 1) demographics, 2)familiarity with genetic research and testing, and 3)willingness to provide a variety of sample types. Descriptive statistics and bivariate chi-square analyses were utilized.

Results: Sample preference variation (N=158) consisted of: 65%, 62% and 18% willing to donate blood, saliva and tissue, respectively. One third (n= 53) endorsed willingness to provide only one form of biological sample (blood, saliva, or tissue). Significant associations were detected between willingness to provide tissue and individuals &lt; 50 years of age (p=0.04). Sample preferences were not otherwise related to age at cancer diagnosis, gender, income, educational status, or familiarity with genetic testing or genetic research.

Conclusions/Impact: Providing options of acceptable biological sample types may yield increased donation from minorities. Inadvertently, this may introduce quality control challenges in obtaining sufficient or multiple forms of biological samples. Identifying additional predictive factors for samples preferences may lead to improvements in methods used to obtain biospecimens from minority populations.

Citation Format: Altovise T. Ewing, Lori AH Erby, Luisel J. Ricks-Santi, Nnenna Kalu, Denise M. Scott. Biospecimen preferences of African-American cancer survivors for cancer genetic research. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1355. doi:10.1158/1538-7445.AM2013-1355

Note: This abstract was not presented at the AACR Annual Meeting 2013 because the presenter was unable to attend.