The Role of Medical Mistrust in Concerns about Tumor Genomic Profiling among Black and African American Cancer Patients

Ariel Hoadley, Sarah Bauerle Bass, Yana Chertock, Jesse Brajuha, Paul D’Avanzo, Patrick J. Kelly and Michael J. Hall
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Ariel Hoadley: Risk Communication Laboratory, Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA 19122, USA
Sarah Bauerle Bass: Risk Communication Laboratory, Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA 19122, USA
Yana Chertock: Fox Chase Cancer Center, Cancer Prevention and Control Program, Department of Clinical Genetics, 333 Cottman Avenue, Philadelphia, PA 19111, USA
Jesse Brajuha: Risk Communication Laboratory, Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA 19122, USA
Paul D’Avanzo: Risk Communication Laboratory, Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA 19122, USA
Patrick J. Kelly: Risk Communication Laboratory, Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA 19122, USA
Michael J. Hall: Fox Chase Cancer Center, Cancer Prevention and Control Program, Department of Clinical Genetics, 333 Cottman Avenue, Philadelphia, PA 19111, USA

IJERPH, 2022, vol. 19, issue 5, 1-14

Abstract: Tumor genomic profiling (TGP) is used in oncology practice to optimize cancer treatment and improve survival rates. However, TGP is underutilized among Black and African American (AA) patients, creating potential disparities in cancer treatment outcomes. Cost, accuracy, and privacy are barriers to genetic testing, but medical mistrust (MM) may also influence how Black and AA cancer patients perceive TGP. From December 2019 to February 2020, 112 Black and AA adults from two outpatient oncology sites in Philadelphia, PA without a known history of having TGP testing conducted completed a cross-sectional survey. Items queried included sociodemographic characteristics, clinical factors, patient–oncologist relationship quality, medical mistrust, and concerns about TGP. A k-means cluster analysis revealed two distinct psychographic clusters: high (MM-H) versus low (MM-L) medical mistrust. Clusters were not associated with any sociodemographic or clinical factors, except for age (MM-H patients older than MM-L patients, p = 0.006). Eleven TGP concerns were assessed; MM-H patients expressed greater concerns than MM-L patients, including distrust of the government, insurance carriers, and pharmaceutical companies. TGP concerns varied significantly based on level of medical mistrust, irrespective of sociodemographic characteristics. Targeted communications addressing TGP concerns may mitigate disparities in TGP uptake among those with medical mistrust.

Keywords: tumor genomic profiling; precision medicine; medical mistrust; cancer health disparities; cluster analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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