Improving Access to Hereditary Cancer Genetic Testing for Black Individuals and Their Families With Darya Kizub, MD

Oncology Data Advisor: Welcome to Oncology Data Advisor. Today, we're here at the ASCO Annual Meeting, and I'm joined by Dr. Darya Kizub. Thank you so much for coming on today.

Darya Kizub, MD: Thank you for inviting me.

Oncology Data Advisor: So, you're about to present your poster about connecting Black families in Houston, Texas, to hereditary cancer genetic counseling and testing. Would you like to give a little bit of background about why you decided to investigate this?

Dr. Kizub: Yes. So, we know that only a small percentage of all cancers are hereditary. For example, only one in 10 breast cancers are hereditary, and it's similar for colorectal cancer. We know also that outcomes in minority populations, specifically among Black patients, are worse for both breast cancer and colorectal cancer. Breast cancer actually has lower incidence in Black women compared with White women, but still has worse outcomes. Colorectal cancer has also worse outcomes in the Black population.

Now, unfortunately, a lot of evidence-based interventions in oncology, including a lot of the more novel interventions and the newer evidence-based guidelines, are not implemented as equally in minority populations, including the Black population. Hereditary cancer genetic testing that is guideline-concordant for breast and colorectal cancer is done more frequently for White patients compared with Black patients. We think that if we can find the Black patients who qualify for hereditary cancer genetic testing, who have not been tested, and provide testing for the people who are at higher risk of cancer, we can give them tools to empower them and their families to reduce their risk of cancer or prevent cancer.

So, this is the reason for our study. We decided to test a novel way of recruiting Black patients and screening them to see if they qualify for hereditary cancer genetic testing. Because a lot of patients don't make it to the primary care doctor, we decided to instead work with trusted community organizations, like Black churches specifically, and also other community organizations to recruit patients.

Oncology Data Advisor: That's awesome. So, how did you go about designing the study and carrying it out?

Dr. Kizub: At MD Anderson, we actually have a center to assist researchers in conducting what is called community participatory research. This is research that directly involves the participants and communities to make sure that the studies are right for them, that they fit their needs, and that they're designed correctly and not too complicated. It's called the Center for Community-Engaged Translational Research.

We collaborated with them because they have close ties with the Black community. The head of our Cancer Disparities Department, Dr. Lorna McNeill, leads a project called Project CHURCH that has a longstanding collaboration with Black churches to implement healthy lifestyle and behavioral change interventions, including for cancer prevention. So, we worked closely with them. They connected us with different community organizations, including churches. They helped us set up a community advisory board to oversee our project. Almost all of our community advisory board members, in addition to providing feedback about the project design and different details of the project, also connected us to the community organizations that they work with.

Then we went to the different meetings. We presented our project. We received feedback, and we started to implement the project. This is a program that's sponsored by Susan G. Komen^®, and they have a program called Worship in Pink. They wanted to actually use this program to implement hereditary cancer genetic testing through Black churches. They worked with a church called the Wheeler Church, where they trained ambassadors to tell the community within the church about this program, and we integrated our program into theirs. We've had multiple avenues for outreach, and so far it's been very well received.

Oncology Data Advisor: That's great. That's a lot of really impressive avenues in the community that you're utilizing.

Dr. Kizub: Thank you.

Oncology Data Advisor: How many patients have been participating so far?

Dr. Kizub: We've attended seven events so far, and this are both church events and health fairs that focus on the Black community. We've had over 100 people who have enrolled so far, so we think the accrual has been going well for the Susan G. Komen^® program. Our goal is to provide genetic testing to 300 individuals and their families, and the program is a little bit more than a third of the way done, so I think we've been doing really well. There has been a lot of interest, and it's been very well received.

As for results, because the trial is in progress, I can't share yet how many people qualified for genetic testing and how many agreed. This will be later on in the process.

Oncology Data Advisor: Right. What are you looking forward most to seeing as the study progresses?

Dr. Kizub: The study so far has been going really well. It's actually been really fun for us as a team to come out to these events to explain the program and to see that people are really excited. They want to know, are they and their family members at risk for breast and colorectal cancer syndromes? What can they do to prevent cancer? It's just been a joy for us to work with community members and to provide the service.

We really want to see what proportion of people qualify for genetic testing, and we do have those preliminary results on how many actually go through with it as well. Then at the end, six months into the program, we'll be measuring program impact, reach, and feasibility, and assessing potential for scale up. I've just had a lot of fun with the program so far, and I'm looking forward to seeing what people think about, "How sustainable is this program? How can we continue it? Can we apply for additional funding?" When we do the formal impact assessment, what will we see? And what are our final results?" I look forward to sharing them.

Oncology Data Advisor: Great, and I look forward to hearing more about it as it progresses. Thanks so much for coming on to talk about this today. It's great to hear about.

Dr. Kizub: Thank you for inviting me again.

About Dr. Kizub

Darya Kizub, MD, is a Hematology-Oncology Fellow in the Division of Cancer Medicine at the University of Texas MD Anderson Cancer Center. Her research interests focus on breast cancer, health care disparities, and global health.

Dr. Banu Arun, Co-Chair of the Department of Clinical Cancer Genetics (CCG) is the lead principal investigator (PI) on this study. The CCG Program at the University of Texas MD Anderson Cancer Center is one of the largest Clinical Cancer Genetics care providers in the nation.

For More Information

McNeill LH, Reitzel LR, Escoto KH, et al (2018). Engaging Black churches to address cancer health disparities: Project CHURCH. Front Public Health, 6:191. DOI:10.3389/fpubh.2018.00191

Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor.