Abstract PO-024: Comparison of urban and rural participants in the cancer-Community Awareness Access Research and Education (c-CARE) Project
Authors: Vernon Marlo M. , Sojourner Samantha , Looney Stephen , Tingen Martha 
Published: December 2020

Abstract
INTRODUCTION. African Americans (AAs) are at greater risk for lung cancer incidence and mortality, especially in rural areas due to low access to healthcare, education, and prevention efforts. AAs have both the highest death rate and the lowest survival rate of any racial or ethnic group for cancer. Georgia’s cancer incidence and mortality rates are higher than national averages, and the rates in rural areas are even higher. The c-CARE research study seeks to impact health disparities by improving lung cancer outcomes in minority and underserved populations in a sustainable and collaborative community-based approach. METHODS: 586 adults (n = 105 rural, 481 urban, 94% AA, 68% female) from historically AA churches and Federally-Qualified Health Centers in east Georgia participated in a four-week educational program with the objectives of providing and facilitating: 1) training and education on risks of lung cancer, 2) importance of and navigation services to low- dose CT screening for eligible participants, 3) evidenced-based smoking cessation for those who are smokers and willing to try to quit, given tobacco use is the number one modifiable risk factor for lung cancer, and 4) training indigenous community health workers (CHWs) to deliver the educational sessions and promote sustainability. Questionnaires assessed healthy lifestyle choices, smoking and cancer screening history, and general knowledge about cancer pre- and post-intervention. Baseline differences between urban and rural participants are reported. RESULTS: There were no significant differences in terms of demographics (age, race, gender, education, health care coverage, income, health status, or primary care provider). 18% of rural and 16% of urban participants reported current smoking or smokeless tobacco use; 65% of rural and 78% of urban planned to quit smoking in the next 6 months. Significantly more urban participants reported: never being exposed to second-hand smoke (48% vs. 32%, p&lt;0.001), a family member with lung (16% vs. 19%, p&lt;0.015) or any type of cancer (59% vs. 89%, p&lt;0.00), and healthcare provider recommendation for lung cancer screening (11.2% vs. 5.0%, p = 0.044). No significant differences were found for high-risk lung cancer classification based on U.S. Preventive Services Task Force (3% vs. 4%) and National Comprehensive Cancer Network (4% vs. 7%) criteria. 72% of rural and 65% of urban participants reported being likely or extremely likely to participate in a clinical trial on cancer treatment.
CONCLUSION: This analysis demonstrates that rural and urban differences exist on lung cancer knowledge, prevention, and other modifiable behavioral risk factors. Efforts to reduce cancer disparities in both incidence and mortality rates are needed in these underserved populations to achieve health equity.
Citation Format: Marlo M. Vernon, Samantha Sojourner, Stephen Looney, Martha Tingen. Comparison of urban and rural participants in the cancer-Community Awareness Access Research and Education (c-CARE) Project [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-024.