Background: Kidney cancer mortality rates are significantly higher among individuals diagnosed with later-stage disease, but there are currently no efficacious methods for kidney cancer screening. As a result, primary prevention via reduction of modifiable risk factors such as smoking, as well prompt diagnosis following early symptoms of the disease, are key to reducing kidney cancer mortality.

Recent research conducted at Southern Illinois University School of Medicine (SIUSOM) has found that rural residents of Southern and Central Illinois have some of the highest kidney cancer incidence and mortality rates in the nation. However, this disparity is not fully explained by the limited number of urologists practicing within this region. Higher rates of smoking, higher thresholds for medical help-seeking behavior, and/or lower levels of health literacy may contribute to the increased incidence and mortality rates within this population, but urban-rural differences in these factors have not be examined within the region.

Partnership Development: To address these critical research gaps, SIUSOM investigators with expertise in urology and clinical trial implementation developed a pilot research project with Washington University in St. Louis (WUSTL) investigators specializing in health behavior and health disparities research. The pilot project was submitted as part of an NCI-funded P20 center exploring the feasibility of building a collaborative partnership between Simmons Cancer Institute at SIUSOM and WUSTL's Siteman Cancer Center.

Research Objectives: The goals of the pilot project are to assess potential geographic differences (urban vs. rural) in: 1) health literacy and cancer literacy; 2) knowledge of smoking as a kidney cancer risk factor; and 3) degree of bother caused by general urologic symptoms. During the development and implementation of the pilot project, the research team is also monitoring the progress and barriers in building new collaborative partnerships that span two institutions located approximately 100 miles apart.

Research Methods: The pilot project is currently enrolling a total of 300 individuals attending primary care or urology clinic appointments in Springfield, IL (n=60); Carbondale, IL (n=120); and St. Louis, MO (n=120). Because the pilot project is designed to assess regional variation in relevant risk factors rather than the relationship between risk factors and kidney cancer development, all clinic patients must be at least 40 years old and must not have a personal history of kidney cancer. Individuals who consent to participate in the study complete a self-administered survey via Android tablet while waiting for their clinic appointment.

Interim Findings: During the pilot project development and implementation phases, we have leveraged existing institutional resources, such as the Research Electronic Data Capture (REDCap) system, to streamline our data collection and management across multiple locations. However, we have encountered some challenges in establishing uniform practices for clinic-based recruitment and enrollment, given the unique clinic organization and patient flow issues in each geographic location. Recruitment and enrollment are currently underway, and preliminary quantitative results will be available by mid-September.

Citation Format: Erin Linnenbringer, Shaheen Alanee, Katina Richardson, Nirek Sharma, Aimee James, Danuta Dynda, Kevin McVary. Development of a New Inter-Institutional Partnership to Assess Health Literacy Disparities in the Context of Kidney Cancer and Smoking. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A83.