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Study Objective Human papillomavirus (HPV) vaccines provide an opportunity to greatly reduce the burden of cervical cancer. Although there has been improvement in uptake, there are notable ethnic/racial disparities. This qualitative study was conducted to better understand factors related to vaccine uptake among female adolescents from 3 racial/ethnic groups: African American (AA), Hispanic, and Caucasian. Findings can inform the development of optimal messages and strategies for clinical and population-based interventions. Design and Setting This mixed-methods descriptive study included completion of a brief structured survey and focus group discussion. Six focus groups were conducted with female adolescents, 2 each in the AA, Hispanic, and Caucasian groups. Brief structured survey questions and the focus group protocol addressed knowledge, perceptions, and behaviors related to HPV, HPV vaccination, and cervical cancer. Participants, Interventions, and Main Outcome Measures Participants were 60 female adolescents (ages 13-19, mean age = 16.6 years) recruited from high schools, public health clinics, and churches. Results Themes across questions were remarkably similar among AA, Hispanic, and Caucasian participants. Each group had high awareness of the terms HPV, HPV vaccination, and cervical cancer, but with little in-depth knowledge about these topics. There was a high acceptance of HPV vaccination. Misperceptions about optimal cervical cancer prevention strategies such as simply knowing one's partner and good hygiene were most common among Hispanic adolescents. Awareness about Pap testing was most common among Caucasian adolescents. Conclusion Predominantly uniform perceptions of HPV vaccines across racial/ethnic groups suggest a “one size fits all” approach will likely have greater reach with cervical cancer prevention messaging than culturally tailored interventions.

Promoting patient-centered care from diagnosis to end of life requires a better understanding of physical, psychological, social, and spiritual coping factors in advanced cancer. Using qualitative methods, the authors explored diagnosis, care planning, and treatment experiences of individuals with metastatic colorectal cancer (N=26). The main physical factors salient to patients during all care phases included symptoms and physical functioning. Key psychological factors included persistent uncertainty and a range of emotions that varied by care phase. Participants also relied heavily on social and spiritual factors for guidance. Results highlight the complex nature of coping with advanced cancer and the resources needed to facilitate high-quality care.

African Americans (AA) have worse stage-specific survival from colorectal cancer (CRC) compared to European Americans (EA), but the reasons for these differences are not well understood. To address this gap in understanding, and to examine racial differences in survival of patients with metastatic colorectal adenocarcinoma (mCRC) by age and prognostic tumor characteristics, we analyzed clinical data from Hollings Cancer Center (HCC) at the Medical University of South Carolina. Because metastatic disease has standard recommendations, a large racial difference in relative survival, and a documented change in chemotherapy usage in 2004, the dataset from HCC is ideal for this analysis. Data were collected by systematic medical record audits of patients diagnosed at HCC between June 2004 and June 2008 with follow-up through June of 2010. Analyses were designed to compare AA to EA by computing medical survival and hazard ratios (HR) and 95% CIs to model the hazard of death as a function of race, controlling for age, sex, and first-line chemotherapy treatment. We also assessed the interaction between race and age and race and clinicopathogic characteristics (i.e. histologic type, location, and grade) and their impact on survival. All tests of statistical significance were two-sided. Data from 82 (27 AA and 55 EA) patients with mCRC were evaluated. Overall survival between AA and EA differed by age, with the racial difference in survival most pronounced among younger (61 years - below the median) compared to older (≥ 61 years - above the median age) patients. Median survival among younger EA and AA was 31 months (95% CI 17-35 months) and 13 months (95% CI 6-17 months), respectively; among older patients, median survival for EA and AA was 22 months (95% CI 8-32 months) and 12 months (95% CI 3-α), respectively. In the younger group, AA had a 2.65 (95% CI 1.24-5.66) times greater risk of death than EA whereas in the older group there was no significant difference (HR 0.93 95% CI 0.39-2.21), a statistically significant interaction (p<0.03). Among the younger CRC cases, AA were more likely than EA to present with mucinous, lower-grade, and colonic carcinomas, even though the AA patients were more likely to die from non-mucinous (p for interaction = 0.04), rectal (p for interaction = 0.06), and higher-grade (p for interaction = 0.12) tumors. In conclusion, the overall poorer survival among AA was concentrated in the younger patients. Despite being less prevalent at diagnosis, the results also indicated that rectal location, non-mucinous histology, and higher tumor grade were associated with poorer survival among the young AA. The reasons for the overall racial disparity being concentrated in the younger patients in unexplained; future studies may consider the role of pathomolecular markers, medical comorbidities, and treatment-related factors to further elucidate etiologies of the disparities seen in younger AA. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5516. doi:1538-7445.AM2012-5516