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Racial Gap in Breast Cancer Genetic Testing

Black Women Less Likely Than Whites to Get Counseling for Genetic Screening
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Who Gets Genetic Testing, Who Doesn't continued...

The group included 217 women who got counseling for genetic screening and 191 who did not. They completed a questionnaire about their decision.

Black women with a family history of breast or ovarian cancer were significantly less likely to get counseling for genetic screening than white women.

Among women with a family history of breast cancer, women who underwent counseling were significantly less likely to be black than women who did not undergo counseling (7.4% vs. 29%).

Women who got counseling for screening tended to have certain traits, such as:

  • White race
  • Greater probability of carrying a BRCA1/2 mutation
  • Younger age
  • More likely to be married
  • More likely to be Jewish
  • Higher education level
  • Higher household income
  • More likely to have talked to their gynecologist or primary care physician about BRCA1/2 counseling
  • Higher perceived breast cancer risk
  • Higher worry about ovarian cancer
  • Attitudes about discrimination
  • Reassurance from testing

Why the Gap?

No reason explained the large black-white gap.

The researchers say it was not due to:

  • Differences in risk factors for carrying a BRCA1/2 gene mutation
  • Socioeconomic factors
  • Risk perception
  • Attitudes
  • Primary care physician recommendations

Type of health insurance coverage was not associated with BRCA1/2 screening. The researchers say they aren't sure if the same patterns hold for women in other cities.

Distrust, Discrimination Fears?

Distrust of the health care system has been shown to be higher among blacks than whites, and new technologies (such as genetic testing) might be particularly sensitive, say researchers.

But only four out of 88 black women who did not get screened agreed with the statement that "testing leads to discrimination." That question didn't specifically get at the possibility of racial discrimination. Some groups may be more reluctant to undergo genetic testing because of concerns about how testing information might be used, write the researchers.

They say that the study further highlights the need to move forward in developing health and social policy that ensures the potential benefit of the Human Genome Project for all segments of the population.

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