Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Tailoring a primary care-based cancer clinical trial for the Chinese community (146108)

Yuhang Zhang 1 2 , Joyce Jiang 3 , Janelle Jones 1 4 , Dorothy Yiu 5 , Wing Siu 5 , Carolyn Ee 6 , Jon Emery 7 , Sibel Saya 1 2
  1. Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
  2. Collaborative Centre for Cancer Genomic Medicine, University of Melbourne, Melbourne, Victoria, Australia
  3. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  4. Primary Care Collaborative Cancer Clinical Trials Group, Melbourne, Victoria, Australia
  5. Chinese Cancer and Chronic Illness Society of Victoria, Melbourne, Victoria, Australia
  6. Western Sydney University, Sydney, New South Wales, Australia
  7. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore

Aims: Risk-stratified cancer screening using polygenic risk scores (PRS) promises more personalised prevention and a better balance of benefits and harms, however, culturally and linguistically diverse (CALD) communities are underrepresented in the trials evaluating it, limiting evidence to support equitable implementation. The CASSOWARY trial is the first Australian trial testing the clinical utility of multi-cancer PRS-guided screening in general practice. We aimed to identify how the CASSOWARY recruitment and intervention could be tailored to inform a culturally adapted pilot trial for the Chinese community in Victoria, one of Australia's largest CALD groups.

Methods: We used a mixed-methods design. Pre- and post-session surveys at a community information session delivered in Mandarin and Cantonese quantified perceived barriers and facilitators to participation. Focus groups with Chinese community members explored these in depth, together with perceptions of the CASSOWARY methods and intervention; transcripts were analysed using reflexive thematic analysis.

Results: Surveys (pre-session n=72, post-session n=57) identified limited knowledge of clinical trials as the primary barrier, followed by language accessibility and safety concerns; GP endorsement was the strongest facilitator, alongside transparency of research motives and accessible question-and-answer opportunities. Six focus groups (n= 43 participants) generated five themes: (1) trust as the fundamental element of participation; (2) linguistic and cultural resonance as a precondition for engagement; (3) cultural meanings of cancer and ambivalence about knowing one's risk; (4) conditional participation—"willing, but on certain terms"; and (5) reframing PRS testing as a safe, personalised, low-risk test rather than being "a guinea pig".

Conclusions: Trust, in-language delivery, cultural framing of cancer risk, and reassurance about test safety are central to engaging the Chinese community. The adapted CASSOWARY pilot will incorporate GP endorsement, culturally resonant Chinese-language communication, transparent safety messaging, accessible question-and-answer opportunities, and flexible participation. These findings provide transferable insights for inclusive primary care cancer trials.