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Access to Breast Cancer Risk Communication and Testing in low-resource settings

Award Number: K43TW013335
ORGANIZATION: FOGARTY INTERNATIONAL CENTER
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2026
PERIOD OF PERFORMANCE END DATE: 07/31/2030

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Access to Breast Cancer Risk Communication and Testing in low-resource settings - Hereditary breast cancer disproportionately affects women of African descent, contributing to higher breast cancer mortality among the estimated 40 million Americans of African ancestry. Standard multi-gene panels yield Variants of Uncertain Significance (VUS) rates of 30–40% in this population due to underrepresentation in global genomic databases, limiting clinical utility for African American patients. Prior work by our research group has demonstrated that genomic discoveries in sub-Saharan African populations have direct applications to African American women, including the identification of ancestry-specific pathogenic variants and tumor biology patterns that inform prevention and treatment in the United States. However, significant portions of sub-Saharan Africa, including East Africa, remain genomically unstudied, representing a critical gap with direct implications for Americans of African descent whose ancestral origins span the continent. Rwanda provides a unique scientific opportunity to address this gap, based on its high pathogenic variant prevalence (18.3%) and understudied mutational landscape representing resources unavailable domestically. Our findings will directly inform variant classification, penetrance estimation, and ascertainment guidelines for African American women through replicable models designed for underserved U.S. communities. In previous work, we identified the most common breast cancer predisposing genes in Rwanda and studied barriers to cancer genetic risk communication among women of African descent in a U.S.-based Cancer Genetic Risk Assessment (CGRA) program. The proposed work broadens access to a diagnosis-driven CGRA program using cost-efficient long-read sequencing technology. The central hypothesis is that resource-adapted tools for cancer genetic risk communication and testing are required to increase understanding of cancer risk and reduce VUS rates in African populations, generating knowledge applicable to improving American health. To test this hypothesis, the proposed aims are: Aim 1: Develop implementation science skills to measure context-appropriate risk communication tools in an Africanbased CGRA program, Aim 2: Validate a low-cost, reduced-gene assay to reduce VUS rates and enable diagnosis-driven genetic testing, and Aim 3: Acquire epidemiology skills to provide population-specific penetrance estimates, refining ascertainment guidelines applicable to women of African descent in Rwanda and the United States. These aims will generate replicable frameworks and genomic knowledge directly improving the health of Americans of African descent, while benefiting thousands of African women and their at-risk family members.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $82,462 )
2026	2026	UNIVERSITY OF RWANDA	KK 737 STREET	KIGALI				RWA	International Research and Research Training	000	1	9/7/2026	NEW	$82,462
														Subtotal = $82,462

Grand Total All Awards = $82,462

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Access to Breast Cancer Risk Communication and Testing in low-resource settings

Award Number: K43TW013335

ORGANIZATION: FOGARTY INTERNATIONAL CENTER

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/01/2026

PERIOD OF PERFORMANCE END DATE: 07/31/2030

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