Abstract PO-251: Examining facilitators and barriers to cancer screening among Black firefighters in South Florida
Authors: Ogunsina Kemi , Solle Natasha , Murphy Lauren A. , Brannan Debi , Bell Keith , McAlister William , Kobetz Erin , Martinez Alberto Caban- 
Published: December 2020

Purpose: Epidemiologic studies of cancer among U.S. firefighters suggest a disproportionate burden of select cancer types including respiratory, gastrointestinal, skin, and kidney when compared to the general population. Although routine colorectal and whole-body skin cancer screening is widely recommended, screening rates among firefighters remain low. The National Fire Protection Association estimates a 1.1 million firefighter workforce, most of whom are Caucasian male, however, sub-groups of women, Hispanic, sexual minority, and Black firefighters are growing. In the present study we describe facilitators and barriers to cancer screening among Black firefighters. Method: A semi-structured interview script was used to conduct five focus group sessions of 45 to 60-minute duration with a total of 22 Black firefighters in South Florida between December 2019 and June 2020. A 20-item demographic survey was administered prior to the start of the interview. Data analysis was conducted using a grounded theory approach and NVIVO 12 software. Qualitative data was analyzed for themes and patterns. Results: Among participating Black firefighters, 90.9% were male, 4.6% Hispanic, 77.3% married, 68.1% with college/master’s educational attainment, 72.7% with private health insurance, 72.7% had a personal doctor, and a group mean age was 44 years (SD ± 8.7 years). Across all focus group sessions, the following three major themes emerged as facilitators and barriers to cancer screening: 1) societal culture of machismo and familial culture; 2) cancer education and cancer awareness; and 3) individual faith. Black firefighters describe culture as influencing health decisions and behaviors throughout their lives, including food choices, receiving a health screening, or visiting a doctor. A second prevalent theme focused on education and cancer awareness; specifically, Black firefighters did not feel comfortable with doctors, particularly because they were Black and firefighters.

Many felt that their doctors are not as aware of racial health differences as they should be, and they had to bring information to their doctors about firefighters’ unique job exposures. Lastly, a third theme describing individual faith influencing cancer screening practices frequently emerged. Many participants reported faith as being very important to them, however, they would not let religious beliefs prevent them from seeking medical interventions when needed. Conclusion: Black societal culture of machismo, cancer education and awareness, and individual faith were identified as facilitators and barriers of cancer screening among Black firefighters in South Florida. Strategies to improve cancer screening and prevention for Black firefighters should consider these factors in the design of workplace cancer interventions for this unique minority occupational subgroup.

Citation Format: Kemi Ogunsina, Natasha Solle, Lauren A. Murphy, Debi Brannan, Keith Bell, William McAlister, Erin Kobetz, Alberto Caban- Martinez. Examining facilitators and barriers to cancer screening among Black firefighters in South Florida [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-251.