Tumor genomic profiling (TGP) is used in oncology practice to optimize cancer treatment and improve survival rates. However, TGP is underutilized among Black and African American (AA) patients, creating potential disparities in cancer treatment outcomes. Cost, accuracy, and privacy are barriers to genetic testing, but medical mistrust (MM) may also influence how Black and AA cancer patients perceive TGP. From December 2019 to February 2020, 112 Black and AA adults from two outpatient oncology sites in Philadelphia, PA without a known history of having TGP testing conducted completed a cross-sectional survey. Items queried included sociodemographic characteristics, clinical factors, patient–oncologist relationship quality, medical mistrust, and concerns about TGP. A k-means cluster analysis revealed two distinct psychographic clusters: high (MM-H) versus low (MM-L) medical mistrust. Clusters were not associated with any sociodemographic or clinical factors, except for age (MM-H patients older than MM-L patients, p = 0.006). Eleven TGP concerns were assessed; MM-H patients expressed greater concerns than MM-L patients, including distrust of the government, insurance carriers, and pharmaceutical companies. TGP concerns varied significantly based on level of medical mistrust, irrespective of sociodemographic characteristics. Targeted communications addressing TGP concerns may mitigate disparities in TGP uptake among those with medical mistrust.

Background/Objectives: Medical mistrust (MM) is associated with adverse health outcomes, but few studies have assessed MM in cancer patients. MM is frequently measured using the Medical Mistrust Inventory (MMI), measuring institutional MM (e.g., government), or the Group-Based Medical Mistrust Scale (GBMMS), measuring race-based MM. We sought to assess the prevalence of MM among cancer patients diverse by age, sex, race/ethnicity, and socioeconomic status (SES), recruited from an urban safety net hospital and a suburban comprehensive cancer center. Methods: Patients completed a one-time survey. The primary outcome was MM as measured by the GBMMS and MMI tools. Covariates included demographics, treatment campus (urban vs. suburban), and psychosocial measures relevant to MM. Results: Purposeful sampling recruitment resulted in 200 participants (survey completion: 74.6%). The median age was 60 years, with 62% female, 45% African-American, 15% Hispanic, 47.5% education ≤ HS diploma, and 51.5% income ≤ USD 50,000/yr. Elevated MMI and GBMMS scores (moderate-to-high) were seen, respectively, in Hispanic (20.7% and 33.4%) and African-American (AA) patients (31.8% and 48.9%), compared with White patients (14.3% and 9.9%). The MMI and GBMMS tools captured complimentary aspects of MM in cancer patients (Spearman’s 0.531, p < 0.0001). MMI was associated with lower education (0.034) and race (p = 0.04), while GBMMS was strongly associated with race (p < 0.001), urban campus (p = 0.035), and mistrust of government/health organization information (both p < 0.05). Higher MMI/GBMMS scores were both associated with research mistrust and mistrust of information from physicians. Conclusions: Institutional and race-based MM are prevalent among cancer patients diverse by age, sex, race/ethnicity, and SES. Lower education was associated with institutional MM but not race-based MM.