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Finding and eliminating causes of low colorectal cancer screening in the territory

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American Samoa Community Cancer Coalition receives $468,966 research grant
Source: ASCCC press release

Pago Pago, AMERICAN SAMOA — The American Samoa Community Cancer Coalition (ASCCC) has been awarded a National Institute of Health AIM-AHEAD grant for $468,996.00. 

AIM-AHEAD's goals are to establish partnerships to increase the participation and representation of researchers and communities that are currently underrepresented in the development of Artificial Intelligence/ Machine Learning (AI/ ML) models and to enhance the capabilities of this emerging technology to address health disparities and inequity.

AIM-AHEAD has developed a national network of academic institutions, stakeholders, and community-based organizations to contribute to these efforts. The AIM-AHEAD consortium has provided funding opportunities to conduct AI/ ML pilot studies and the ASCCC was one of 22 pilot projects funded this year.

The study is a result of the ASCCC’s INSPIRE program funded by the NIH’s National Institute of Minority Health and Health Disparities program. INSPIRE conducted research to determine if health literacy was a contributing factor to low colorectal cancer (CRC) screening.  The 2013 Behavioral Risk Factor Surveillance System (BRFSS) reported only 7% of eligible adults had been screened for CRC.  Unpublished results from INSPIRE found a statistically significant association and the ASCCC moved forward with a pilot to test modified patient education materials using plain language to increase CRC screening. 

Participants (were divided into two groups: 1) received unedited fecal occult blood test (FOBT) instructions and a FOBT kit and 2) received the plain language FOBT instructions and a FOBT kit.  Both groups were given 2 weeks to report, however, only 10% returned the kits. Further discussion revealed the handling of fecal matter can be interpreted as taboo or uncomfortable.  Since then, finding innovative ways for CRC screening that are culturally appropriate has been a priority.

The study has two specific aims: 1) build infrastructure to conduct AI/ ML research, and 2) assess the use of an AI/ ML algorithm to increase colorectal cancer detection for American Samoa adults ages 50 and above.  

The results of the study will help to understand and evaluate AI/ ML techniques in healthcare as it has advanced medical fields including screening, diagnosing, and treatment of Colorectal Cancer (CRC).  

This will be the first research study to utilize and assess AI/ ML tools to address health disparities and a step towards using today’s technology to advantage. Mr. Va’atausili Tofaeono, the study’s principal investigator, explained, “We will use a complete blood count (CBC) test and demographic information to create a predictive CRC score that a physician can then determine if the patient is at high risk. We will also collect blood samples for genetic testing.” 

This innovative approach helps to eliminate the cultural barriers of the traditional FOBT test kit while increasing AI/ ML knowledge in Indigenous populations. 

The study is a collaboration between partners including Lyndon B. Johnson Tropical Medical Center, Medial EarlySigns, and the University of Hawaii Cancer Center.  “We are excited to work with our partners, especially LBJ Tropical Medical Center and CEO Moefa’auo William Emmsley who are in support of using advanced technologies to improve health in the community,” Tofaeono said.