Concerns about cancer risk and experiences with genetic testing in a diverse population of patients with breast cancer

J Clin Oncol. 2015 May 10;33(14):1584-91. doi: 10.1200/JCO.2014.58.5885. Epub 2015 Apr 6.

Abstract

Purpose: To evaluate preferences for and experiences with genetic testing in a diverse cohort of patients with breast cancer identified through population-based registries, with attention to differences by race/ethnicity.

Methods: We surveyed women diagnosed with nonmetastatic breast cancer from 2005 to 2007, as reported to the SEER registries of metropolitan Los Angeles and Detroit, about experiences with hereditary risk evaluation. Multivariable models evaluated correlates of a strong desire for genetic testing, unmet need for discussion with a health care professional, and receipt of testing.

Results: Among 1,536 patients who completed the survey, 35% expressed strong desire for genetic testing, 28% reported discussing testing with a health care professional, and 19% reported test receipt. Strong desire for testing was more common in younger women, Latinas, and those with family history. Minority patients were significantly more likely to have unmet need for discussion (failure to discuss genetic testing with a health professional when they had a strong desire for testing): odds ratios of 1.68, 2.44, and 7.39 for blacks, English-speaking Latinas, and Spanish-speaking Latinas compared with whites, respectively. Worry in the long-term survivorship period was higher among those with unmet need for discussion (48.7% v 24.9%; P <.001). Patients who received genetic testing were younger, less likely to be black, and more likely to have a family cancer history.

Conclusion: Many patients, especially minorities, express a strong desire for genetic testing and may benefit from discussion to clarify risks. Clinicians should discuss genetic risk even with patients they perceive to be at low risk, as this may reduce worry.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Americans / genetics
  • African Americans / psychology
  • African Americans / statistics & numerical data*
  • Age Factors
  • Aged
  • Breast Neoplasms / epidemiology*
  • Breast Neoplasms / ethnology
  • Breast Neoplasms / genetics*
  • Communication
  • European Continental Ancestry Group / genetics
  • European Continental Ancestry Group / psychology
  • European Continental Ancestry Group / statistics & numerical data*
  • Family
  • Female
  • Genetic Testing*
  • Health Personnel
  • Hispanic Americans / genetics
  • Hispanic Americans / psychology
  • Hispanic Americans / statistics & numerical data*
  • Humans
  • Los Angeles / epidemiology
  • Michigan / epidemiology
  • Middle Aged
  • Odds Ratio
  • Risk Assessment
  • Risk Factors
  • SEER Program
  • Surveys and Questionnaires
  • United States