Abstract B023: Cancer patient experiences communicating positive genetic testing results to family members: A comparison of African American and White patient perspectives

Abstract Background: Genetic testing (GT) for inherited cancer risk is increasingly used in cancer patients to identify a germline pathogenic variant (PV) to guide cancer treatments and screening and prevention of second cancers, but also serves an important role in identifying at risk relatives (ARR) who may be at increased risk of cancer and benefit from early detection and cancer prevention once a PV has been identified in the family. Most PVs confer a 50% risk of inheritance among first degree relatives. Thus, it is critically important that GT results be communicated to ARR after PV has been identified in the family. Studies have demonstrated that up to 40% of ARR are unaware of the familial PV. There has been limited research on racial differences in communication experiences of GT to ARR and little is known about support needs to effectively facilitate communication of results. Methods: Virtual, semi-structured interviews (N=12) were conducted in cancer patients with an identified PV from June 2024 to March 2025 at an urban academic medical center. Interviews explored GT experiences, communication of GT results to ARR, and support needs for communication of GT to ARR. Interviews were audio recorded, transcribed, coded, and analyzed using thematic analysis to identify impressions of racial differences in patient experiences. Results: Both groups expressed a willingness to share GT results with family. White patients reported sharing the results with immediate family members while Black patients also shared results with extended family members. Black patients reported a lack of understanding of GT results. Both groups desired more educational information related to GT results. Black patients preferred educational online resources to facilitate sharing GT results with ARR, while White patients preferred educational pamphlets. Both groups described the need for more comprehensive support from healthcare teams about GT process, including educational support about testing outcomes, familial education, clear timelines for testing of ARR. For Black patients, support needs centered on the desire for increased education about the results to allow for the patients to better understand the results and also be able to explain them to ARR. White patients support needs centered around more information about testing outcomes, genetic testing processes for their family members, and more streamlined care. Conclusions: From our initial interviews, we found that both Black and White patients were willing to share their GT results with ARR, but there was a higher lack of understanding of GT results among Black patients that presents a clear barrier to accurate and meaningful communication of results to ARR. When given permission by patient, direct healthcare provider disclosure of GT to ARR may overcome this barrier. White patients would benefit from clearer guidance on the steps and timelines for ARR to complete GT. Funding: American Association of Cancer Research Career Development Award to Further Diversity, Equity, and Inclusion in Clinical Cancer Research Citation Format: Kristen D. Whitaker, Caseem C. Luck, Bat-zion Hose, Katie Singley, Eberechukwu Muoneke, Murad Wali, Simrahn Bidaye, Imani Askew-Shabazz, Arianna Vacio, Emma Clarke, Preeti Shastri, Kidist Dugassa, Sarah B. Bass. Cancer patient experiences communicating positive genetic testing results to family members: A comparison of African American and White patient perspectives [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B023.