Details:

Alternative Title:
Cancer
Personal Author:
Cragun, Deborah ; Weidner, Anne ; Lewis, Courtney ; Bonner, Devon ; Kim, Jongphil ; ... More +
Cragun, Deborah ; Weidner, Anne ; Lewis, Courtney ; Bonner, Devon ; Kim, Jongphil ; Vadaparampil, Susan T. ; Pal, Tuya Less -
Description:
Background

Breast cancer (BC) disparities may widen with genomic advances. We compared non-Hispanic white (NHW), Black, and Hispanic BC survivors for: 1) cancer risk management practices (CRM) among BRCA carriers; and 2) provider discussion and receipt of genetic testing.

Methods

A population-based sample of NHW, Black, and Hispanic women diagnosed with invasive BC ≤ age 50 in 2009–2012 were recruited through the state cancer registry. Using multiple logistic regression we compared CRM in BRCA carriers and association of demographic and clinical variables with provider discussion and receipt of testing.

Results

Of the 1622 participants, 36.1% (159/440) Blacks, 64.5% (579/897) NHW, 49.6% (58/117) Spanish-speaking Hispanics, and 69.0% (116/168) English-speaking Hispanics had BRCA testing, of whom 90 had a pathogenic BRCA mutation. Among BRCA carriers, RRM and RRSO rates were significantly lower among Blacks compared to Hispanics and NHW after controlling clinical and demographic variables (p=0.025 and 0.008, respectively). Compared to NHW, discussion of genetic testing with a provider was 16 times less likely among Blacks (p<0.0001) and nearly two times less likely among Spanish-speaking Hispanics (p=0.04) after controlling clinical and sociodemographic factors.

Conclusions

Our results suggest lower rates of RRSO among Black compared to Hispanic and NHW BRCA carriers, which is concerning as benefits from genetic testing arise from CRM options. Furthermore, lower BRCA testing rates among Blacks may partially be due to lower likelihood of provider discussion. Future studies are needed to improve cancer risk identification and management practices across all populations to prevent the widening of disparities.


Subjects:
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Adult Black Or African American Breast Neoplasms Ethnicity Female Genes, BRCA1 Genes, BRCA2 Genetic Testing Healthcare Disparities Hereditary Breast And Ovarian Cancer Syndrome Heterozygote Hispanic Or Latino Humans Logistic Models Middle Aged Multivariate Analysis Ovarian Neoplasms Ovariectomy Prophylactic Mastectomy Prophylactic Surgical Procedures Risk Assessment Salpingectomy Survivors White People
Source:
Cancer. 123(13):2497-2505
Pubmed ID:
28182268
Pubmed Central ID:
PMC5474124
Document Type:
Journal Article
Funding:
P30 CA076292/CA/NCI NIH HHS/United States ; R25 CA147832/CA/NCI NIH HHS/United States ; T32 CA147832/CA/NCI NIH HHS/United States ; U50 DP424071/DP/NCCDPHP CDC HHS/United States
P30 CA076292/CA/NCI NIH HHS/United States ; R25 CA147832/CA/NCI NIH HHS/United States ; T32 CA147832/CA/NCI NIH HHS/United States ; U50 DP424071/DP/NCCDPHP CDC HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:880b8ecabc1e74bbb26208f1c14a04504734285193db4b9fab15880673c68351
Download URL:
https://stacks.cdc.gov/view/cdc/46326/cdc_46326_DS1.pdf
File Type:

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