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Disparities in BRCA counseling across providers in a diverse population of young breast cancer survivors

Abstract

Purpose

All women diagnosed with breast cancer (BC) ≤age 50 should be referred for genetic counseling (GC) and testing. We sought to compare differences in provider practices and access across a racially and ethnically diverse population of young BC survivors.

Methods

A registry-based sample of women diagnosed with invasive BC ≤age 50 from 2009 to 2012 was recruited through the Florida Cancer Registry, and completed a questionnaire and medical record release. Differences were compared across those tested with or without the involvement of a board-certified or credentialed genetics health professional (GHP) in (1) clinical and demographic variables and (2) pretest GC elements.

Results

Of 1622 participants, there were 440 Blacks, 285 Hispanics, and 897 Non-Hispanic Whites. Of 831 participants with medical record verification of testing provider, 170 (20%) had documentation of GHP involvement. Among the 613 who recalled a pretest discussion and had GC elements collected, those with GHP involvement were significantly more likely to recall the seven recognized GC elements.

Conclusion

GHP involvement was associated with adherence to nationally recommended best practices. With the expanding importance of identifying inherited cancers, it is critical to ensure equitable access to best practices across all populations.

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Acknowledgements

This work was supported by grants from the Bankhead Coley granting agency (4BB15 and IBG10–34199) and the National Cancer Institute (NCI) (R01 CA204819), and in part by the Ingram Professorship, the Kleberg Foundation, and by Vanderbilt Genetic Institute departmental funds (T.P.). Support for S.R.’s time was provided by a NCI T32 training grant awarded to Vanderbilt University (T32 CA160056).

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Correspondence to Tuya Pal MD.

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Reid, S., Cragun, D., Tezak, A. et al. Disparities in BRCA counseling across providers in a diverse population of young breast cancer survivors. Genet Med 22, 1088–1093 (2020). https://doi.org/10.1038/s41436-020-0762-0

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Keywords

  • hereditary breast cancer
  • genetic testing
  • genetic counseling
  • genetics health professional

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