GUIAR: Promoting lung cancer screening in Hispanic head and neck cancer survivors.
Authors: Olazagasti Coral , Crane Tracy E , Rodriguez Estelamari , Horiguchi Miki , Penedo Frank J. , Florez Narjust , Kobetz Erin N. , Lopes Gilberto 
Published: October 2024

TPS1643

Background:
Hispanics are the leading racial/ethnic group in Miami Dade. Miami has the highest number of Hispanics diagnosed with lung cancer (LC) in the U.S. Hispanics have worse LC mortality than Non-Hispanic Whites, partly due to lower rates of LC screening (LCS) and exclusionary eligibility leading to advanced LC diagnoses. Even with more liberalized criteria, the rates of LCS uptake in eligible participants was 5.8% in 2022. This number is expected to be even lower for Hispanics, though quantifiable data to assess the trends in this population does not exist. Besides tobacco use, a previous cancer poses a risk for LC. The incidence of LC in head and neck cancer (HNC) survivors is almost double than the average population. However, no prospective studies have been conducted in this space. In this clinical trial, we aim to create the first LCS program tailored to Hispanic HNC survivors.
Methods:
Our study received IRB approval by University of Miami (UM) [NCT06124508]. We will pre-screen all subjects with HNC treated from 2012-2017 to determine their eligibility. We will enroll 125 participants who will complete a survey to assess awareness and disposition to LCS. All will be referred to UM’s LCS program. A total of 62 Participants will undergo 1:1 randomization to a tailored educational intervention vs standard of care. The intervention consists of annual 60-minute visits with a nurse navigator with tailored education in the participant’s native language about LC risk factors, LCS eligibility, and LCS process. Subjects in the intervention arm will also complete a semi-structured interview to explore cultural beliefs and barriers to LCS. For Hispanic HNC survivors, our primary aim is to assess awareness and disposition to LCS. Secondary aims include: To learn barriers to LCS; To create and test a tailored a LCS program; and to compare the rates of LCS uptake between arms at baseline and year 1. Data analysis for the baseline survey: Descriptive statistics will be used to summarize the demographic, clinical characteristics, and responses. The outcomes of interest are the proportion of patients who are aware of LCS recommendations and willing to pursue LCS and identifying demographic and clinical characteristics that are related to awareness of the recommendations. Data analysis for the qualitative interview: We will use a modified form of grounded theory46 to analyze the interview transcripts. Qualitative data will be analyzed using a constant comparative method to develop themes from the data by coding and analyzing at the same time using NVivo10 Software. Data analysis for the randomized study: All randomized patients who complete the Year1 survey will be included in the analysis. We will compare the uptake rates of LCS between baseline and year-1 in each arm using McNemar’s test. Fisher’s exact test will be used for comparing the rates between the arms. The same analyses will be performed for the awareness rate. Clinical trial information: 20220746.