A qualitative study of genomics in cancer control for Aboriginal and Torres Strait Islander Australians

OBJECTIVE: To describe the perspectives of Aboriginal and Torres Strait Islander peoples and health care workers on genomics in cancer care to inform the National Framework for Genomics in Cancer Control (the Framework). METHODS: A total of 37 Aboriginal and Torres Strait Islander community members, health care workers, researchers, and Aboriginal community-controlled health sector representatives participated in five in-person workshops around Australia. Data were audio recorded, transcribed and analysed using reflexive thematic analysis. RESULTS: Discussions of genomics in cancer control yielded six themes. Culture describes the cultural considerations for genomics. Self-determination describes the need for informed decision making in genomic healthcare and research. Capacity building identifies areas for improving education and awareness. Workforce identifies specific roles needed to support Aboriginal access to genomics. Access describes the barriers and enablers for genomics in cancer control. Suggested actions for integrating genomics into cancer care outlines participants' call to action. CONCLUSIONS: Equitable access to precision medicine for cancer control will be strengthened by co-design with and for Aboriginal and Torres Strait Islander peoples. IMPLICATIONS FOR PUBLIC HEALTH: The findings from this study informed the development of the Framework, which will guide Australia's cancer control sector in the use of genomics.