Factors associated with genetic counseling and BRCA testing in a population-based sample of young Black women with breast cancer
Factors associated with genetic counseling and BRCA testing in a population-based sample of young Black women with breast cancer
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DOI：
10.1007/s10549-015-3374-7
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发表时间：
2015-05-01
影响因子：
3.8
通讯作者：
Pal, Tuya
中科院分区：
文献类型：
--
作者：
Cragun, D.;Bonner, D.;Pal, Tuya
人们对基因组进步可能会增加健康差距的担忧已经引起了人们的关注。因此，评估遗传性乳腺癌和卵巢癌 (HBOC) 高风险少数群体的遗传咨询 (GC) 和检测的转诊和接受情况非常重要。 2009 年至 2012 年，诊断患有浸润性乳腺癌（千分之 50）的黑人女性在诊断后 6 至 18 个月内通过佛罗里达州癌症登记处招募，并完成了基线调查问卷。进行汇总统计、卡方检验和路径建模来检查哪些人口和临床变量与转诊和获得遗传服务相关。在 440 名参与者中，全部符合 GC 国家标准，但只有 224 名 (51%) 被转介接受 GC 和/或 HBOC 测试。与医疗保健提供者转诊 GC 最密切相关的变量包括大学教育程度 (OR 2.1)、45 岁或以下的诊断年龄 (OR 2.0) 和三阴性肿瘤受体状态 (OR 1.7)。与接受 GC 和/或 HBOC 检测的最强关联是医疗保健提供者转诊 (OR 7.9)，其次是诊断时的私人健康保险 (OR 2.8)，以及诊断前一年的家庭收入超过 35,000 美元 (OR 2.0)。研究结果表明，需要努力改善基于人群的高风险黑人女性样本中遗传服务的获取。这些结果表明，社会经济因素和医生转诊模式导致了这一服务不足的少数群体在获得遗传服务方面的差异。
Concerns about the potential for genomic advances to increase health disparities have been raised. Thus, it is important to assess referral and uptake of genetic counseling (GC) and testing in minority populations at high risk for hereditary breast and ovarian cancer (HBOC). Black women diagnosed with invasive breast cancer a parts per thousand currency signage 50 in 2009-2012 were recruited through the Florida State Cancer Registry 6-18 months following diagnosis and completed a baseline questionnaire. Summary statistics, Chi-square tests, and path modeling were conducted to examine which demographic and clinical variables were associated with referral and access to genetic services. Of the 440 participants, all met national criteria for GC, yet only 224 (51 %) were referred for or received GC and/or HBOC testing. Variables most strongly associated with healthcare provider referral for GC included having a college education (OR 2.1), diagnosis at or below age 45 (OR 2.0), and triple negative tumor receptor status (OR 1.7). The strongest association with receipt of GC and/or HBOC testing was healthcare provider referral (OR 7.9), followed by private health insurance at diagnosis (OR 2.8), and household income greater than $35,000 in the year prior to diagnosis (OR 2.0). Study findings suggest efforts are needed to improve genetic services access among a population-based sample of high-risk Black women. These results indicate that socioeconomic factors and physician referral patterns contribute to disparities in access to genetic services within this underserved minority population.