Study looks at factors influencing African-American women's decisions to join cancer screening trial

December 01, 2005

PITTSBURGH, Dec. 1 - Do African-American women who join a screening trial for cancer differ from those who do not join? Researchers at the University of Pittsburgh's Graduate School of Public Health sought to answer this question by surveying African-American women who were invited to join the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, a randomized, community-based longitudinal study evaluating the effectiveness of cancer screening tests on site-specific mortality.

Their results, published in today's issue of the Journal of Clinical Oncology, indicate that African-American women who decided to join PLCO held significantly different beliefs regarding the benefits and risks of participation than those who did not join - the majority of those who joined were much more likely to report that African-Americans benefit as much as whites from participating in clinical trials. Interestingly, the study also found that none of the women surveyed had reported learning about clinical trials from their doctors or other health care providers.

"By interviewing women who joined the PLCO as well as those who did not, we were able to analyze their responses and suggest a strategy for improving the recruitment of African-American women to cancer clinical trials," said Jeanette Trauth, Ph.D., lead author of the study and associate professor of behavioral and community health sciences, University of Pittsburgh Graduate School of Public Health.

The researchers interviewed 299 African-American women between the ages of 55 and 74 who were eligible for the PLCO; 230 of these women decided not to participate in PLCO (non-joiners) and 69 of these women decided to participate in PLCO (joiners). The investigators found that joiners had a better understanding of cancer and the role of early detection and screening, and appeared to be motivated to join a trial by the experience of having a loved one with cancer. Joiners also tended to seek out information more than non-joiners and were willing to take the next step and take part in a study of a new treatment for a health problem that they perceived was important, especially if they or one of their loved ones had the problem.

Although there were differences between the groups, there also were similarities. The two groups had similar attitudes about cancer and their susceptibility to PLCO cancers. Most joiners and non-joiners alike, 73 and 72 percent respectively, agreed that if meant to get cancer, a woman would get it regardless of what she did to prevent it. However, they did not think having cancer was automatically a death sentence. The majority of both groups also reported that they would be unlikely to get lung, colon or ovarian cancer during their lifetimes.

One of the most striking findings was that none of the participants in the study reported their doctor had talked to them about joining a clinical trial. "This represents a major missed opportunity to impart vital educational information and to recruit African-American women more successfully into clinical trials," said Dr. Trauth.

To increase recruitment of African-American women to cancer clinical trials, Dr. Trauth suggests first providing women a health benefit that they want and need. She also suggests creating registries of African-American women interested in participating in clinical trials from current or former participants; informing physicians about the importance of talking to their patients about clinical trial opportunities; engaging African-American women in a dialogue about their perceptions of clinical trials; and providing them with the tools they need to make informed decisions.
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The study was funded by a grant from the National Cancer Institute. Co-authors of the study include Jan Jernigan, Ph.D., Laura Siminoff, Ph.D., Donald Musa, Dr.PH., Derietra Neal-Ferguson, R.N., M.P.H., and Joel Weissfeld, M.D., M.P.H.

University of Pittsburgh Medical Center

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