Abstract C080: Contributors to breast and lung cancer disparities in Wisconsin: Results from statewide focus groups and interviews
Authors: Salazar Jose , Olson Jessica , Cawthra Tobi , Stolley Melinda , Millon-Underwood Sandra , Beyer Kirsten , Fraser David , Ignace Lyle , Pinsoneault Laura , Walker Alonzo , Williams Carol , Maurana Cheryl 
Published: August 2020

Abstract
Background: Despite advances in breast and lung cancer research, racial and geographic disparities persist in Wisconsin. The Wisconsin Cancer Reporting System indicates that disparities in lung cancer mortality rates, as well as breast cancer incidence and mortality between black and white populations, have significantly worsened in the past decade. Root causes for these cancer-related health disparities are complex and multifactorial and require innovative approaches to be resolved. A comprehensive understanding of the unique contributors to breast and lung cancer disparities in the state of Wisconsin is required.
Methods: To explore root causes of breast and lung cancer disparities and opportunities to address them, we engaged more than 100 stakeholders from across the research and community spectrum, including basic scientists, population health experts, clinicians, community and nonprofit leaders, community health workers, community members, federally qualified health center and free clinic directors, and public health professionals. We utilized a flexible discussion format responsive to participant needs (i.e., one-on-one interviews, small group discussions at conferences, and focus groups). Sessions were tailored specifically to each group, to accommodate differences in style, language including appropriate vernacular, format, and familiarity with the topic.
Results: Our most compelling finding was that no group (researchers, community organizers, educators, etc.) felt that their group had the capacity to significantly reduce cancer disparities through their efforts alone but recognized the unique knowledge and skills they could contribute. Researchers without established disparities focus shared that they are aware of health disparities and are willing to contribute to reduction efforts but did not intuitively know ways to leverage their skills. Conversely, community leaders understood the value of their work, but many believed that their efforts were meant to inform larger research-based initiatives. Both community and research groups emphasized the role of stress, the impact of health care quality and medical mistrust, the connection to environmental exposures (social and physical), as well as the factors influencing risk behaviors.
Conclusions and Future Directions: Each stakeholder group interviewed revealed unique opportunities to reduce disparities in breast and lung cancer incidence, late-stage diagnosis, and mortality, but shared a feeling that cross-sector collaborations are critical to make an impact. These results will inform the assembly of multidisciplinary work groups to assess the complex, multifactorial contributors to breast and lung cancer disparities revealed in these interviews and develop novel strategies to address them.
Citation Format: Jose Salazar, Jessica Olson, Tobi Cawthra, Melinda Stolley, Sandra Millon-Underwood, Kirsten Beyer, David Fraser, Lyle Ignace, Laura Pinsoneault, Alonzo Walker, Carol Williams, Cheryl Maurana. Contributors to breast and lung cancer disparities in Wisconsin: Results from statewide focus groups and interviews [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C080.