RACED (Reduction of Cervical Cancer Disparities): The impact of navigators and racial literacy training.

Abstract

TPS1660 Background: Cervical cancer is the third most prevalent cancer in Brazilian women. Approximately 17,000 new cases are expected for Brazil’s 2023-2025 triennium. The complex multimodality treatment of locally advanced cervical cancer (LACC), which relies on platinum-based chemoradiotherapy (CRT) and brachytherapy (BT), in addition due to the significant healthcare demands of patients with cervical cancer, creates challenges for a public-funded health system. The Black population experiences the highest cancer mortality rates compared to the general population, partly due to inequalities in social, economic, political, and health areas spheres. Data showed that, compared to White women, the mean age-adjusted mortality rates according to race/skin color were 27% higher in Black women. Around 60% of Black patients have a cervical cancer diagnosis in locally advanced or advanced stages. The incidence rate among Black women was found to be significantly higher than that of their White counterparts, with a relative risk of incidence nearly 50% higher. This disparity cannot be ignored. Methods: Our study is based on Critical Racial Praxis for Public Health. It is inspired by the ACCURE (Accountability for Cancer Care Through Undoing Racism and Equity) initiative trial, composed of 3 anti-racist actions: 1- oncology navigation with racial literacy, 2- real-time medical record alert system, and 3- race-specific feedback. Our intervention, in turn, consists of oncology navigation with racial inequities training and improving interprofessional team knowledge about race and diversity through race-specific feedback. This prospective, single-center, non-randomized clinical trial of anti-racist actions and treatment support will compare prospective patients with a historical control from the same hospital. The primary endpoint is to increase the completion rate of definitive treatment with CRT+BT for 100 patients with IB2 to IVA cervical cancer (convenience sample). The secondary endpoints are to analyze the implementation policy of this strategy and to make an economic assessment of the use of this implementation (we hypothesize that such measures reduce both visits to the emergency room due to toxicity, as well as admissions to wards and ICU). Patient inclusion is expected to begin in March 2025. Nurses are receiving training in oncology navigation and racial literacy in healthcare. As this is a race-conscious trial, the researchers plan to prospectively compare outcomes between the intervention group’s Black/Brown and non-Black/Brown populations. In addition, given critical race theory, the research team comprises Black women in creation, design, and throughout the entire study continuum. Clinical trial information: 85819325.0.0000.0068 .