Abstract PR06: Different places, same problems: Tales of Deep South and Midwestern young African American breast cancer survivorship care
Authors: Nolan Timiya S. , Addison Sarah , Andersen Barbara , Lustberg Maryam 
Published: December 2020

Abstract
Background Breast cancer survival rates continue to improve, yet disparities in breast cancer survivorship outcomes (e.g., higher mortality and poorer quality of life) exist. The paucity of culturally sensitive interventions for women from underrepresented racial-ethnic backgrounds only further exacerbates disparities in survivorship care. Young women, less than age 45, who are African American (AA) breast cancer survivors (BCS) experience disparate survivorship outcomes and are often understudied. Without representation, existing frameworks for survivorship care and their delivery may not meet the needs of this growing population of survivors. The purpose of this paper is to describe young AA breast cancer survivorship care in the Deep South (Alabama, Louisiana, and Mississippi) and Midwestern (Ohio) regions. Methods Semi-structured interviews were conducted with young AA BCS and healthcare providers. Fifteen young AA BCS living in the Deep South and six young AA BCS living in the Midwest responded to questions about their lived experiences of breast cancer survivorship including changes in quality of life, adverse effects of diagnosis and treatment, and experiences with/ preferences for survivorship care delivery. Six Midwestern healthcare providers responded to questions about their experiences caring for young AA BCS. Interviews were transcribed verbatim and placed in NVivo 12 software for thematic analysis within and between data from young AA BCS and healthcare providers. Two-independent coders analyzed then iteratively compared codes. Inter-coder agreement was met in determination of the final coding scheme. Results Themes emerged within young AA BCS (mean age = 38 years; years of survivorship = 3 years): management of survivorship along with “everyday” age- and socioculturally-related challenges, communication of survivorship care lacks representation, and care coordination to address survivorship needs is not always ideal. Themes within healthcare provider interviews were: young AA BCS experience changes throughout survivorship that challenge their well-being, care individualization is provided but may not involve cultural humility, and healthcare providers need more training on supportive care options. The cross-cutting theme across all groups indicates that young AA BCS have unmet needs that should be addressed with targeted interventions as they navigate survivorship care. Conclusion Deep South and Midwestern young AA BCS report similar experiences of life after a breast cancer diagnosis, which are largely congruent with healthcare providers’ observations. Despite this concordance between young AA BCS and healthcare providers, survivorship care is often lacking supportive interventions that are targeted to manage the needs of young AA BCS. More work is needed to define best practices for survivorship care that operationalizes cultural humility to promote equitable survivorship outcomes among young AA BCS.
Citation Format: Timiya S. Nolan, Sarah Addison, Barbara Andersen, Maryam Lustberg. Different places, same problems: Tales of Deep South and Midwestern young African American breast cancer survivorship care [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 PR06.