Setting the Tone: Communication of Endometrial Cancer Diagnosis and Perceived Support at Treatment Initiation Among Black Women in the Social Interventions for Support During Treatment for Endometrial Cancer and Recurrence Study ID 1225

INTRODUCTION: Black endometrial cancer (EC) patients experience disparately high rates of aggressive EC requiring arduous adjuvant therapy, for which treatment adherence is critical. Dissatisfaction with provider communication and insufficient information delivery are known barriers to treatment adherence and may affect this high-risk population. We aimed to characterize Black EC patients’ experiences of provider communication during the diagnostic process immediately preceding treatment by leveraging The Social Interventions for Support During Treatment for Endometrial Cancer and Recurrence (SISTER) Study, a 13-site national randomized controlled trial that enrolled newly diagnosed Black women with high-risk EC. METHODS: We performed a secondary analysis of 45 qualitative interviews conducted prior to treatment initiation among SISTER Study participants. Interviews were audiorecorded, transcribed, and coded using the Consolidated Framework for Implementation Research. We generated themes regarding the diagnostic process, informational needs, and perceptions of support. RESULTS: Participants who received clear, compassionate explanations during the diagnostic process felt well-supported and comfortable seeking further information from their care team. Repeated check-ins were also valued for emotional and informational support. Conversely, participants who experienced brief, overly technical, vague, or seemingly apathetic diagnostic communication reported confusion, fear, and higher informational needs. Social networks and online sources were common avenues of alternative support. CONCLUSIONS/IMPLICATIONS: Clear and compassionate communication during the diagnostic process—which often includes conversations with generalists, primary care physicians, and gynecologic oncologists—positively affects participants’ sense of informational and social support for EC treatment. There is a need for a collaborative, multidisciplinary information-delivery approach to improve the quality of care for Black EC patients.