Genetic Literacy and Patient-Caregiver Communication of Prognostic Genetic Technology for Localized Prostate Cancer

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Project Summary/Abstract Novel genomic technology, such as microarray analyses and next-generation sequencing, have improved the understanding of prostate cancer biology and prognosis. The National Comprehensive Cancer Network (NCCN), in 2016, recommended that patients and clinicians consider tissue-based genetic tests for localized prostate cancer. However, while much enthusiasm currently exits for the rapidly increasing field of genomic medicine, the use of multi-gene mRNA expression panels raises the potential for further divergence in prostate cancer treatment outcomes by race and low socioeconomic status. We know that health disparities persist in low income groups despite the existence of evidence-based guidelines and that adoption of state-of-the-art methods often lag behind in these groups. The goals of this NCI K01 application are to (1) explore how men with localized prostate cancer and their caregivers comprehend prognostic genetic technology, and (2) examine how an educational video about genetics impacts patient-caregiver communication of prognostic genetic technology. The study rationale is that without direct attention to genomic comprehension, the enthusiasm that exists in the rapidly increasing field of prostate cancer genomic medicine may not translate into health benefits for men with localized prostate cancer. The central hypotheses are (1) men and caregivers with lower levels of education will demonstrate a severe lack of genomic comprehension of tissue-based genetic tests for localized prostate cancer; and (2) tailored prostate cancer education, communication coaching, and a genomic literacy educational video will significantly improve patient-caregiver communication in a low literacy population. The study approach is innovative because it applies a mixed-methods community-engagement research framework to explore how African American and rural White men with localized prostate cancer, comprehend and interpret data generated from genetic technology. The proposed research is significant because of its potential to improve public health by (1) improving the understanding of prognostic genetics in minority, low income, and rural populations, and (2) engage and educate these diverse communities about genomics. The proposed research, in combination with a structured mentoring and training plan that includes didactic course and workshops, is designed to facilitate Dr. Ewan Cobran’s long term goal of developing an independently-funded research program in prostate cancer disparities, consistent with the mission of the NCI.