$3.2 million grant aids in the study of genetic testing approach to close racial disparity gaps in cancer care

With the aid of a near $3.2 million National Cancer Institute grant (R01CA277599) recently awarded, investigators from the state's leading cancer program, Rutgers Cancer Institute of New Jersey,  and Georgetown University's Lombardi Comprehensive Cancer Center, both NCI-designated Comprehensive Cancer Centers, will work to close racial disparity gaps in cancer care delivery by examining a novel approach to genetic testing and care based on community-identified needs.

Genetic testing is a powerful tool used to identify a person's risk for developing certain cancers that run in families. Identifying patients with a genetic alteration that increases susceptibility or predisposition to a certain disease is crucial to customize cancer treatment and guide primary and secondary prevention. However, there are low referral and genetic testing rates among racial minorities, especially among Blacks. The study, led by principal investigators Anita Kinney, PhD, RN, FAAN, FABMR, professor at the Rutgers School of Public Health and associate director for Community Outreach and Engagement at Rutgers Cancer Institute, and Marc Schwartz, PhD, associate director for Population Science at Georgetown Lombardi Comprehensive, will address this translational gap and explore ways to improve access to genetic testing and reduce disparities by identifying Black families who may benefit from precision prevention, screening, and medical management of cancers. They are joined in this effort by collaborators from MedStar Health Research Institute and RWJBarnabas Health.

Currently, many health care systems and commercial genetic testing laboratories use digital interventions, including videos and chatbots, instead of traditional pre-test genetic counseling sessions with a genetic risk specialist. In this newly funded study, investigators propose use of a community-engaged, culturally tailored and interculturally competent care delivery model that involves community engagement in the development, implementation and evaluation in oncology settings to eliminate racial disparities in genomic health care delivery.

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"This approach to genetic testing could benefit Black patients and their relatives because they are often unaware of their risk for cancer and less likely to have a healthcare provider discuss their risk or refer them for this type of testing," said Dr. Kinney, who is also the director of the Cancer Health Equity Center of Excellence at Rutgers School of Public Health and Rutgers Cancer Institute and director of ScreenNJ, a statewide cancer prevention and screening program.

Given the potential life-saving benefits of genetic testing, understanding how to effectively engage and test high-risk families in a culturally acceptable way will help reduce persistent racial disparities. This grant will help us further explore that approach."

Dr. Anita Kinney, PhD, RN, FAAN, FABMR, Professor at the Rutgers School of Public Health

In response to community identified needs, investigators will enroll 428 Black cancer patients who meet the national guidelines for genetic testing for hereditary cancer into a randomized controlled trial. The study aims to compare the efficacy of a culturally tailored approach that incorporates an interactive digital genetic counseling assistant versus enhanced usual care on genetic education engagement and testing uptake. The impact on genetic testing utilization, informed decision-making and psychosocial outcomes will be evaluated. Dr. Schwartz says, "Data from this trial can be used to guide clinical practice and policy decisions for advancing cancer health equity and improving access to genetic education and genetic testing." If successful, this approach could be applied to other chronic conditions.

The project period runs for 5 years.