Abstract
Factors influencing cancer treatment decisions require comprehension of genetic tests, risk stratification, and treatment options. This comprehension in turn requires understanding of numeracy, genetic literacy, health literacy, and medical trust, all important for acceptance and implementation of precision medicine. Using a mixed methods approach, we sought to identify patient-level factors influencing the understanding of cancer risk and precision medicine among community health center patients. At a community health center in Nashville, Tennessee we enrolled 26 English-speaking patients between the ages of 40-79 years who were either a cancer patient (n=4), had a family member with cancer (n=20), and/or were previously a caregiver for a cancer patient (n=15). The participants enrolled in one of four focus groups, and also completed surveys to assess patient-level understanding of precision medicine, numeracy, and health literacy. We used a three-item health literacy screening questionnaire and the Subjective Numeracy Scale to assess health literacy and numeracy, respectively. Participants were median age 60, 89% African American and 77% female, with 35% having a high school degree or less and 35% a household income of ≤$15,000. While health literacy was generally high (≤15% reported low confidence in filling out medical forms, understanding medical information, or needing help to read the information), 42% felt that genes or genetics had little impact on health and most reported little familiarity with precision medicine (69%), pharmacogenetics (77%), biomarkers (81%) or biobanks (81%). The majority of participants reported that trust in their providers was extremely or very important when receiving genetic tests (77%) and over 60% felt receiving genetic test results was extremely important. Numeracy levels were moderate, with nearly half reporting some discomfort working with fractions and 38% finding numerical information only occasionally useful. The findings suggest that many patients lack familiarity with precision medicine concepts relevant for understanding cancer treatment decisions. Future efforts in digital technologies may be able to help bridge the gap in patient understanding and allow medically underserved populations to have equitable opportunities for precision medicine.
Citation Format: Melinda C Aldrich, William J Blot. Assessing patient-level knowledge of precision medicine in a community health center setting [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D086.
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