NCI Awards VCU Massey Cancer Center $4.25 Million to Study Delays and Disparities in Colon Cancer

By Andrea Butler
Massey Cancer Center

The National Cancer Institute has awarded two grants totaling more than $4.25 million to a Virginia Commonwealth University Massey Cancer Center researcher for two studies to examine delays and disparities in colon cancer diagnosis.

“African Americans get more colon cancer and die from it more often than their white counterparts,” said principal investigator Laura A. Siminoff, Ph.D., associate director of the Cancer Prevention and Control research program at Massey. “If we can gain a better understanding of how physicians respond to patients who may have colon cancer, as well as how patients respond to their own symptoms, we may be able to develop programs and tools that will lead to earlier diagnosis, which could help to reduce mortality rates from this disease.” 

Siminoff, a nationally recognized expert on health communication and decision- making in disease treatment, also chairs the VCU School of Medicine’s Department of Social and Behavioral Health. In these roles, she and colleagues focus on understanding how social, cultural and behavioral factors affect public health, and educating the public to make lifestyle and other changes to improve the standard of health. Their emphasis is on cancer, chronic disease and healthcare disparities among various populations.

The first study will focus on appraisal delays and disparities in timely colon cancer diagnosis.  “Appraisal delay” describes patients with difficulty identifying and interpreting their symptoms that can impede their reporting of symptoms to healthcare providers.

The study will examine whether appraisal delay is more prevalent in African American cancer patients. Researchers will interview recently diagnosed patients to identify how patients interpreted their symptoms and acted on them. The study will use cognitive interviewing, the administration of standardized instruments and chart reviews to obtain data.

The NCI will support the study with $1.4 million over three years.

The second study will test whether or not primary care physicians communicate with patients differently depending on race and gender. It uses an innovative method with trained actors to simulate four patients -- an African American man and woman and a Caucasian man and woman – who will visit 110 primary care physicians unannounced and present prediagnosis symptoms of colon cancer. The researchers will compare the communication patterns and subsequent patient management decisions made by the physicians to see if there are any patterns of diagnostic delays (inactions or incorrect actions) to make a diagnosis.

“As in real life, each patient will have a story and a set of symptoms,” said Siminoff. “We’ll be focused on how the doctors communicate with them and what they recommend as next steps for the patients. As we examine the data, we will look for any patterns that show whether patients were treated differently based on their race or gender.”

The study’s design, training, implementation and data analysis is expected to take five years and is supported by a $2.89 million NCI grant.