Abstract PO-238: Implementing a culturally-appropriate biospecimen collection protocol during the COVID-19 pandemic to address cervical cancer disparities among Native American women
Authors: Bordeaux Skyler , Martinez Elisa , Laniewski Pawel , Metz Natalie , Quioz Verity , Peace Donna , Caporaso Gregory , Herbst-Kralovetz Melissa , Lee Naomi 
Published: January 2022

Background: Native American women experience twice the rate and mortality of cervical cancer compared to non-Hispanic white women. This cervical cancer disparity is primarily attributed to a lack of screening and unequal access to healthcare. While infection with high-risk HPV genotypes is a well-established risk factor for cervical cancer, there are likely other factors within the local microenvironment that contribute to cervical carcinogenesis. Therefore, the goal of the pilot project is to address the role of the vaginal microbiome (VMB) and inflammation in cervical cancer pathogenesis among Native American women. In 2019, we partnered with the Native Americans for Community Action (NACA) clinic to implement a culturally-appropriate biospecimen protocol. Unfortunately, the COVID-19 pandemic caused NACA and many clinics nation-wide to limit in-patient services or transition to 100% telehealth. As such, preventative care such as breast and cervical cancer screenings were not conducted during the annual well women's exam. Another hurdle in our pilot project included the resignation of the trained nurse in consenting, enrollment, collection and storage at NACA. Therefore, we needed to quickly adapt to accommodate the clinic's COVID-19 restrictions and train a new nurse on the biospecimen collection protocol. Methods: Adjustments to the protocol included vaginal self-collection rather than physician collection of samples. We also provided new clinic staff a “virtual in-service training” to review all required documents (recruitment, consenting, sample collection, gift cards, specimen storage, etc.). Recruitment was slow during the early stage of the COVID-19 vaccine roll out. Therefore, we developed culturally tailored recruitment flyers that were distributed over social media. In addition, we developed a culturally appropriate video on the significance of the well women's exam through collaboration with the NACA clinic and researchers at the partnership for Native American Cancer Prevention (NACP) that will be disseminated in the upcoming weeks. All amendments were approved by the clinic leadership and appropriate institutional review boards (IRBs). Results: As COVID-19 restrictions lifted, the NACA staff was prepared to immediately begin recruitment. Thus far, the NACA staff successfully enrolled (n=25) participants since March 2020 with survey data entered into REDCap. With continued recruitment efforts and launch of the video, we aim to have at least 50% of participants enrolled by Fall 2021. Survey data analyses are in-progress with expected completion by Spring 2022. Conclusion: In summary, the continued efforts by the NACA staff and research team resulted in successful recruitment for the pilot study during the COVID-19 pandemic. This study will set the foundation to evaluate the role of the VMB and HPV-mediated cancer in Native American women.

Citation Format: Skyler Bordeaux, Elisa Martinez, Pawel Laniewski, Natalie Metz, Verity Quioz, Donna Peace, Gregory Caporaso, Melissa Herbst-Kralovetz, Naomi Lee. Implementing a culturally-appropriate biospecimen collection protocol during the COVID-19 pandemic to address cervical cancer disparities among Native American women [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-238.