Abstract C25: Series of breast cancer brochures for American Indian addressing breast cancer disparities
Authors: Gunville Jordyn , Lewis Charley , Berryhill Kelly , Wilkie Crissandra , Pacheco Joseph , Daley Christine 
Published: March 2017

Abstract
Breast cancer mortality disproportionately affects American Indians, with one-half of the newly diagnosed cases at regional or distant metastasis. Low screening rates are a primary reason for the disproportionate number of late-stage diagnoses in this under-served community. American Indians are also under-represented in clinical trials and other research, as well as in the health and research professions. The lack of American Indian researchers has a direct impact on the number of studies conducted with American Indians and the poor rates of mammography and other breast cancer screenings. The AIHREA/ Susan G. Komen Scholars in American Indian Breast Cancer Disparities seek to increase the number of American Indian researchers trained in breast cancer research to reduce disparities in their communities.
Breast cancer is the second leading cause of cancer mortality among American Indian (AI) and Alaska Native (AN) women, who have the lowest 5-year survival rates of all racial/ethnic groups. AI/AN women are twice as likely to die from breast cancer than non-Hispanic white women. Incidence rates have risen steadily over the last 50 years. Although incidence rates among AI/AN women are lower than for other racial/ethnic groups (67.2/100,000 women versus 125.3/100,000 women for all ethnic groups),10 more AI/AN women are diagnosed with late-stage breast cancers than other racial/ethnic groups, with 44% of newly diagnosed cases staged at regional or distant metastasis, compared to 33% among non-Hispanic whites. Breast cancer incidence rates among AI/AN women differ by geographic region, with rates as high as 139.5/100,000 women in Alaska and as low as 50.4/100,000 women in the Southwest. Recent data show that breast cancer incidence may be significantly under-reported among AI/AN women due, in large part, to racial misclassification.
To help reduced the disparities in breast cancer screening we created five culturally tailored brochures. Focus groups with American Indian community members were used to determine topics for the brochures titled BRCA Facts, BRCA Screening, BRCA Positive Screen, BRCA Someone You Love, and BRCA Men. After drafting the brochures they were edited focusing on access for scientific accuracy by using a panel of experts, then checking the readability level by using Suitability Assessment of Materials, followed by checking the cultural appropriateness by receiving feedback from community members at events such as powwows. Culturally appropriate imagery was added and adjustments were made according to the feedback we received. The finalized brochures are now available to the American Indian tribes, organizations and individuals.
Citation Format: Jordyn Gunville, Charley Lewis, Kelly Berryhill, Crissandra Wilkie, Joseph Pacheco, Christine Daley. Series of breast cancer brochures for American Indian addressing breast cancer disparities. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C25.