Promoting Equity in Genetic Evaluation for Prostate Cancer Among Hispanic/Latinx Men
Abstract
Objective and Rationale: Prostate cancer may be inherited in families and many genes contribute to prostate cancer risk. For patients with prostate cancer, genetic testing is important to identify genetic mutations that may impact the type of treatment that is given and possible opportunities for clinical trials. Genetic testing may also reveal mutations that increase the risk of other types of cancer for patients and their family members, which informs screening recommendations and other risk-reduction strategies. Despite the importance of genetic testing, Hispanic males with prostate cancer have less engagement with genetic counseling and testing than non-Hispanic white men. The reasons for this disparity are not currently known but might include the patient’s comfort level with English and access to the healthcare system, the knowledge and experience of health care providers with genetic testing, and awareness about the importance of genetics to prostate cancer risk and treatment among the general population. The potential contribution of these and other factors to the limited uptake of genetic testing by Hispanic patients with prostate cancer will be investigated in the current study, as well as actionable ways to address them. First, we will analyze online content about prostate cancer genetics in English and Spanish from the most commonly used search engine (Google) and social media platform (YouTube). We will assess the quality and understandability of information on these platforms, as well as whether and how ethnic disparities are portrayed. We will also conduct an online survey of U.S. Hispanic men on their knowledge about prostate cancer genetics and attitudes toward genetic testing. Next, we will carry out interviews with Hispanic patients with prostate cancer and healthcare providers about the specific barriers and facilitators of genetic testing, and also their opinion on the type of informational resources that would be most useful to raise awareness and promote equitable uptake. Finally, in collaboration with community partners and foundations, we will create a bilingual website with important information about inherited prostate cancer, genetic testing, and precision oncology. We will use sponsored online advertisements in English and Spanish to raise awareness about prostate cancer genetics and to share the website more broadly. Applicability of the Research: Our study is the first analysis of factors underlying the low rate of genetic testing among Hispanic men with prostate cancer, despite clinical recommendations to the contrary. In the long term, this work could increase uptake of genetic testing, resulting in direct clinical benefits for Hispanic patients with prostate cancer and their families. It is also the first study to examine the quality of online materials about prostate cancer genetics in English and Spanish, and to identify gaps in available health information content and public awareness of prostate cancer genetics. We will use this information to design a new bilingual website that will be freely shared with patients, providers, and the general public. One risk is that some people do not have Internet access or use online networks for prostate cancer information and therefore may not directly benefit from the online resources that we create. However, given that Hispanic Americans have the highest rates of internet (95%) and social media (80%) use among U.S. adults, and that use of these platforms continues to increase among older adults, it is important that high-quality, culturally relevant information is available. Our team includes experts in urology, medical oncology, clinical cancer genetics, health disparities, qualitative research, and biostatistics. We will also work alongside an advisory board including Hispanic patients with prostate cancer, a caregiver, and a community educator to provide guidance on the study and to help disseminate the results
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252311040
Entities
People
- Stacy Loeb
Organizations
- Grossman School of Medicine
- United States Army