Presenting Author: Shanada Monestime, PharmD, BCOP, GO2 for Lung Cancer, San Carlos, CA
BACKGROUND: Lung cancer is the leading cause of cancer death in the United States. Black communities, compared with other marginalized groups, have the highest mortality rates, driven by disproportionate late-stage diagnoses, barriers to biomarker testing, and limited opportunities for clinical trial participation. Yet, the voices of Black patients and caregivers remain underrepresented, because most studies have concentrated on populations with a comparatively lower burden.
OBJECTIVE: To explore barriers and perceptions related to clinical trials, biomarker testing, and supportive care needs among Black adults diagnosed with or caring for someone with lung cancer.
METHODS: We conducted a mixed-methods descriptive study in Washington, DC, and Baton Rouge, LA, which are 2 regions with a high lung cancer burden and marked racial disparities, where Black residents have incidence and mortality rates approximately 1.5 to 2.9 times higher than White residents. Eligible participants were aged ≥18 years, self-identified as Black, and had lung cancer or were caregivers of such individuals. Semi-structured virtual interviews incorporated narrative inquiry and structured ranking exercises to capture preferences related to decision-making, clinical trials, and support needs. Transcripts were analyzed in ATLAS.ti using an inductive approach, and the ranking data were summarized descriptively with mean scores calculated to identify priority concerns.
RESULTS: A total of 12 participants were included (50% patients and 50% caregivers; 75% female; 92% diagnosed at stage III-IV). Three central themes were identified in the narrative analysis. First, participants described delays in diagnoses and fragmented care driven by dismissal of symptoms and insurance-related barriers. Second, most had limited awareness of biomarker testing and reported it as never explained or offered. Third, perceptions of clinical trials were mixed, with interest in participation tempered by mistrust, fear of adverse events (AEs), and unclear provider communication. The most urgent concerns identified by ranking exercises included understanding treatment options (mean, 2.25), managing AEs (mean, 3.41), and improving provider communication/self-advocacy (mean, 4.41). One-on-one guidance from a dedicated health professional (mean, 1.42) and access to a 24-hour, 7-day helpline (mean, 3.0) were ranked as the most valuable support formats.
CONCLUSION: This study highlights critical gaps in timely diagnosis, education on biomarker testing and clinical trials, and provider communication for Black adults diagnosed with or caring for someone with lung cancer. Pharmacists can be leveraged to deliver one-on-one guidance, trusted education, and navigation support, offering a pathway to reduce disparities and improve equity in lung cancer care.
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