Intergenerational Communication of Cancer Care, Risk, and Prevention Among Black American Families: A Scoping Review

Background: Black Americans suffer from a substantial burden of cancer in the United States. For most major cancers, Black Americans have a higher cancer mortality rate and a lower 5-year survivorship rate than White Americans. They are often diagnosed at later stages of the disease and are negatively impacted by treatment disparities. Recent attention has turned to understanding the genetic components of cancer and focusing on the family health history as an early intervention point. Intergenerational communication is important to facilitate sharing family health history regarding cancer care, but not much is currently known about communication methods and patterns regarding intergenerational communication of family cancer health history. The objective of this review is to assess the extent of the literature regarding intergenerational communication about cancer prevention, risk, and care among Black communities.

Methods: Adhering to the Arksey and O’Malley framework and the Whelphan extension, we conducted a scoping review of the literature. To be included in this review articles must 1) focus on communication in Black or African American families, 2) English speaking, 3) discuss cancer care, risk, or prevention, and 4) participants over the age of 18. Using Medical Subject Headings (MeSH) terms we searched Pubmed, Embase, Scopus, and Web of Science, for appropriate articles from inception to November 2024. In addition, we used Quality Assessment Tool for Reviewing Studies with Diverse Designs (QATSDD) to assess the quality of included articles.

Results: In total, 334 titles and abstracts were initially screened by two reviewers using the systematic review web-based tool Covidence. Thirty-eight articles meet criteria for full text review, 29 articles were excluded for wrong patient population, outcomes, or study design. Nine articles were deemed to have meet criteria and were included within this review. Six of the included studies were qualitative, two were cross sectional, and one mixed method design. Common barriers to family cancer communication included generational differences in views on privacy, reluctance to share due to fear and stigma, self-efficacy, and family cohesion. When information was shared, it was often between women of the family as a way of passing down family health history.

Conclusions and Implications: Early intervention and screening is important to reduce cancer health disparities. The current literature is a starting place for understanding communication practices and methods, however an opportunity exists to further refine this information and begin exploring intervention development. Social work researchers and practitioners have the opportunity to facilitate and encourage family cancer health history sharing amongst Black families.