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Clinical Cancer Genetics Disparities among Latinos

  • Review Paper
  • Published:
Journal of Genetic Counseling

Abstract

The three major hereditary cancer syndromes in Latinos (Hereditary Breast and Ovarian Cancer, Familial Adenomatous Polyposis and Lynch Syndrome) have been shown to exhibit geographic disparities by country of origin suggesting admixture-based disparities. A solid infrastructure of clinical genetics geared towards diagnosis and prevention could aid in reducing the mortality of these cancer syndromes in Latinos. Currently, clinical cancer genetic services in Latin America are scarce. Moreover, limited studies have investigated the mutational spectrum of these cancer syndromes in Latinos resulting in gaps in personalized medicine affecting diagnosis, treatment and prevention. The following commentary discusses available genotype and clinical information on hereditary cancer in Latinos and highlights the limited access for cancer genetic services in Latin America including barriers to genetic testing and alternatives for providing better access to genetic services. In this review, we discuss the status of clinical genetic cancer services for both US Latinos and those Latinos living in Latin America.

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References

  • Avena, S., Via, M., Ziv, E., Perez-Stable, E. J., Gignoux, C. R., Dejean, C., et al. (2012). Heterogeneity in genetic admixture across different regions of Argentina. PloS One, 7(4), e34695. doi:10.1371/journal.pone.0034695PONE-D-11-17545.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Barreiro, C. Z., Bidondo, M. P., Garrido, J. A., Deurloo, J., Acevedo, E., Luna, A., et al. (2013). CHACO outreach project: the development of a primary health care-based medical genetic service in an Argentinean province. Journal of Community Genetics, 4(3), 321–334. doi:10.1007/s12687-013-0157-x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bureau, U. S. C. (2013). 2010 Census.

  • Castilla, E. E., & Luquetti, D. V. (2009). Brazil: public health genomics. Public Health Genomics, 12(1), 53–58. doi:10.1159/000153424.

    Article  CAS  PubMed  Google Scholar 

  • Cruz-Correa, M., Diaz-Algorri, Y., Perez-Mayoral, J., Suleiman-Suleiman, W., Gonzalez-Pons Mdel, M., Bertran, C., et al. (2015). Clinical characterization and mutation spectrum in Caribbean Hispanic families with lynch syndrome. Familial Cancer, 14(3), 415–425. doi:10.1007/s10689-015-9795-y.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Dutil, J., Colon-Colon, J. L., Matta, J. L., Sutphen, R., & Echenique, M. (2012). Identification of the prevalent BRCA1 and BRCA2 mutations in the female population of Puerto Rico. Cancer Genetics, 205(5), 242–248. doi:10.1016/j.cancergen.2012.04.002.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Dutil, J., Golubeva, V. A., Pacheco-Torres, A. L., Diaz-Zabala, H. J., Matta, J. L., & Monteiro, A. N. (2015). The spectrum of BRCA1 and BRCA2 alleles in Latin America and the Caribbean: a clinical perspective. Breast Cancer Research and Treatment, 154(3), 441–453. doi:10.1007/s10549-015-3629-3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Eichmeyer, J. N., Northrup, H., Assel, M. A., Goka, T. J., Johnston, D. A., & Williams, A. T. (2005). An assessment of risk understanding in Hispanic genetic counseling patients. Journal of Genetic Counseling, 14(4), 319–328. doi:10.1007/s10897-005-0759-5.

    Article  PubMed  Google Scholar 

  • Gammon, A. D., Rothwell, E., Simmons, R., Lowery, J. T., Ballinger, L., Hill, D. A., et al. (2011). Awareness and preferences regarding BRCA1/2 genetic counseling and testing among Latinas and non-Latina white women at increased risk for hereditary breast and ovarian cancer. Journal of Genetic Counseling, 20(6), 625–638. doi:10.1007/s10897-011-9376-7.

    Article  PubMed  Google Scholar 

  • Giraldo, A. (2004). Genetic services in Colombia. Community Genetics, 7(2–3), 126–129. doi:10.1159/000080782.

    PubMed  Google Scholar 

  • Gonzalez-Andrade, F., & Lopez-Pulles, R. (2010). Ecuador: public health genomics. Public Health Genomics, 13(3), 171–180. doi:10.1159/000249817.

    Article  CAS  PubMed  Google Scholar 

  • Heck, J. E., Franco, R., Jurkowski, J. M., & Sheinfeld Gorin, S. (2008). Awareness of genetic testing for cancer among United States Hispanics: the role of acculturation. Community Genetics, 11(1), 36–42. doi:10.1159/000111638.

    PubMed  Google Scholar 

  • Honda, K. (2003). Who gets the information about genetic testing for cancer risk? The role of race/ethnicity, immigration status, and primary care clinicians. Clinical Genetics, 64(2), 131–136.

    Article  CAS  PubMed  Google Scholar 

  • Horovitz, D. D. G., de Faria Ferraz, V. E., Dain, S., & Marques-de-Faria, A. P. (2013). Genetic services and testing in Brazil. Journal of Community Genetics, 4(3), 355–375. doi:10.1007/s12687-012-0096-y.

    Article  PubMed  Google Scholar 

  • Jagsi, R., Griffith, K. A., Kurian, A. W., Morrow, M., Hamilton, A. S., Graff, J. J., et al. (2015). Concerns about cancer risk and experiences with genetic testing in a diverse population of patients with breast cancer. Journal of Clinical Oncology, 33(14), 1584–1591. doi:10.1200/JCO.2014.58.5885.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kinney, A. Y., Gammon, A., Coxworth, J., Simonsen, S. E., & Arce-Laretta, M. (2010). Exploring attitudes, beliefs, and communication preferences of Latino community members regarding BRCA1/2 mutation testing and preventive strategies. Genetics in Medicine, 12(2), 105–115. doi:10.1097/GIM.0b013e3181c9af2d.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kofman-Alfaro, S., & Penchaszadeh, V. B. (2004). Community genetic services in Latin America and regional network of medical genetics. Recommendations of a World Health Organization consultation. Community Genetics, 7(2–3), 157–159. doi:10.1159/000080789.

    PubMed  Google Scholar 

  • Lagos, V. I., Perez, M. A., Ricker, C. N., Blazer, K. R., Santiago, N. M., Feldman, N., et al. (2008). Social-cognitive aspects of underserved Latinas preparing to undergo genetic cancer risk assessment for hereditary breast and ovarian cancer. Psychooncology, 17(8), 774–782. doi:10.1002/pon.1358.

    Article  PubMed  Google Scholar 

  • Levy, D. E., Byfield, S. D., Comstock, C. B., Garber, J. E., Syngal, S., Crown, W. H., & Shields, A. E. (2011). Underutilization of BRCA1/2 testing to guide breast cancer treatment: black and Hispanic women particularly at risk. Genetics in Medicine, 13(4), 349–355. doi:10.1097/GIM.0b013e3182091ba4.

    Article  PubMed  PubMed Central  Google Scholar 

  • Marcheco, B. (2009). Cuba's national medical genetics program. MEDICC Review, 11(1), 11–13.

    PubMed  Google Scholar 

  • Margarit, S. B., Alvarado, M., Alvarez, K., & Lay-Son, G. (2013). Medical genetics and genetic counseling in Chile. Journal of Genetic Counseling, 22(6), 869–874. doi:10.1007/s10897-013-9607-1.

    Article  PubMed  Google Scholar 

  • Pagan, J. A., Su, D., Li, L., Armstrong, K., & Asch, D. A. (2009). Racial and ethnic disparities in awareness of genetic testing for cancer risk. American Journal of Preventive Medicine, 37(6), 524–530. doi:10.1016/j.amepre.2009.07.021.

    Article  PubMed  Google Scholar 

  • Palmero, E. I., Ashton-Prolla, P., da Rocha, J. C., Vargas, F. R., Kalakun, L., Blom, M. B., et al. (2007). Clinical characterization and risk profile of individuals seeking genetic counseling for hereditary breast cancer in Brazil. Journal of Genetic Counseling, 16(3), 363–371. doi:10.1007/s10897-006-9073-0.

    Article  PubMed  Google Scholar 

  • Penchaszadeh, V. B. (2000). Community genetics in Latin America: challenges and perspectives. Community Genetics, 3, 124–127.

    Google Scholar 

  • Penchaszadeh, V. B. (2009). Argentina: public health genomics. Public Health Genomics, 12(1), 59–65. doi:10.1159/000153429.

    Article  CAS  PubMed  Google Scholar 

  • Penchaszadeh, V. B. (2013). Genetic testing and services in Argentina. Journal of Community Genetics, 4(3), 343–354. doi:10.1007/s12687-012-0093-1.

    Article  PubMed  Google Scholar 

  • Penchaszadeh, V. B. (2015). Ethical issues in genetics and public health in Latin America with a focus on Argentina. Journal of Community Genetics, 6(3), 223–230. doi:10.1007/s12687-015-0217-5.

    Article  PubMed  PubMed Central  Google Scholar 

  • Penchaszadeh, V. B., & Beiguelman, B. (1998). Medical genetic services in Latin America: report of a meeting of experts. Revista Panamericana de Salud Pública, 3(6), 409–420.

    Article  CAS  PubMed  Google Scholar 

  • Pinheiro, P. S., Sherman, R. L., Trapido, E. J., Fleming, L. E., Huang, Y., Gomez-Marin, O., & Lee, D. (2009). Cancer incidence in first generation U.S. Hispanics: Cubans, Mexicans, Puerto Ricans, and new Latinos. Cancer Epidemiology, Biomarkers & Prevention, 18(8), 2162–2169. doi:10.1158/1055-9965.EPI-09-0329.

    Article  Google Scholar 

  • Ramirez, A. G., Aparicio-Ting, F. E., de Majors, S. S., & Miller, A. R. (2006). Interest, awareness, and perceptions of genetic testing among Hispanic family members of breast cancer survivors. Ethnicity & Disease, 16(2), 398–403.

    Google Scholar 

  • Ricker, C., Lagos, V., Feldman, N., Hiyama, S., Fuentes, S., Kumar, V., et al. (2006). If we build it ... Will they come?--establishing a cancer genetics services clinic for an underserved predominantly Latina cohort. Journal of Genetic Counseling, 15(6), 505–514. doi:10.1007/s10897-006-9052-5.

    Article  PubMed  Google Scholar 

  • Rodriguez, R. C., Esperon, A. A., Ropero, R., Rubio, M. C., Rodriguez, R., Ortiz, R. M., et al. (2008). Prevalence of BRCA1 and BRCA2 mutations in breast cancer patients from Cuba. Familial Cancer, 7(3), 275–279. doi:10.1007/s10689-008-9187-7.

    Article  CAS  PubMed  Google Scholar 

  • Siegel, R. L., Fedewa, S. A., Miller, K. D., Goding-Sauer, A., Pinheiro, P. S., Martinez-Tyson, D., & Jemal, A. (2015). Cancer statistics for Hispanics/Latinos, 2015. CA: a Cancer Journal for Clinicians, 65(6), 457–480. doi:10.3322/caac.21314.

    Google Scholar 

  • Sussner, K. M., Thompson, H. S., Valdimarsdottir, H. B., Redd, W. H., & Jandorf, L. (2009). Acculturation and familiarity with, attitudes towards and beliefs about genetic testing for cancer risk within Latinas in East Harlem, New York City. Journal of Genetic Counseling, 18(1), 60–71. doi:10.1007/s10897-008-9182-z.

    Article  PubMed  Google Scholar 

  • Sussner, K. M., Jandorf, L., Thompson, H. S., & Valdimarsdottir, H. B. (2010). Interest and beliefs about BRCA genetic counseling among at-risk Latinas in New York City. Journal of Genetic Counseling, 19(3), 255–268. doi:10.1007/s10897-010-9282-4.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sussner, K. M., Jandorf, L., Thompson, H. S., & Valdimarsdottir, H. B. (2013). Barriers and facilitators to BRCA genetic counseling among at-risk Latinas in New York City. Psychooncology, 22(7), 1594–1604. doi:10.1002/pon.3187.

    Article  PubMed  Google Scholar 

  • Sussner, K. M., Edwards, T., Villagra, C., Rodriguez, M. C., Thompson, H. S., Jandorf, L., & Valdimarsdottir, H. B. (2015). BRCA genetic counseling among at-risk Latinas in New York City: new beliefs shape new generation. Journal of Genetic Counseling, 24(1), 134–148. doi:10.1007/s10897-014-9746-z.

    Article  PubMed  Google Scholar 

  • Suther, S., & Kiros, G. E. (2009). Barriers to the use of genetic testing: a study of racial and ethnic disparities. Genetics in Medicine, 11(9), 655–662. doi:10.1097/GIM.0b013e3181ab22aa.

    Article  PubMed  Google Scholar 

  • Thompson, H. S., Valdimarsdottir, H. B., Jandorf, L., & Redd, W. (2003). Perceived disadvantages and concerns about abuses of genetic testing for cancer risk: differences across African American, Latina and Caucasian women. Patient Education and Counseling, 51(3), 217–227.

    Article  PubMed  Google Scholar 

  • Vadaparampil, S. T., Wideroff, L., Breen, N., & Trapido, E. (2006). The impact of acculturation on awareness of genetic testing for increased cancer risk among Hispanics in the year 2000 National Health Interview Survey. Cancer Epidemiology, Biomarkers & Prevention, 15(4), 618–623. doi:10.1158/1055-9965.EPI-05-0378.

    Article  Google Scholar 

  • Vadaparampil, S. T., Quinn, G. P., Small, B. J., McIntyre, J., Loi, C. A., Closser, Z., & Gwede, C. K. (2010a). A pilot study of hereditary breast and ovarian knowledge among a multiethnic group of Hispanic women with a personal or family history of cancer. Genetic Testing and Molecular Biomarkers, 14(1), 99–106. doi:10.1089/gtmb.2009.0088.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vadaparampil, S. T., McIntyre, J., & Quinn, G. P. (2010b). Awareness, perceptions, and provider recommendation related to genetic testing for hereditary breast cancer risk among at-risk Hispanic women: similarities and variations by sub-ethnicity. Journal of Genetic Counseling, 19(6), 618–629. doi:10.1007/s10897-010-9316-y.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vadaparampil, S. T., Quinn, G. P., Dutil, J., Puig, M., Malo, T. L., McIntyre, J., et al. (2011). A pilot study of knowledge and interest of genetic counseling and testing for hereditary breast and ovarian cancer syndrome among Puerto Rican women. Journal of Community Genetics, 2(4), 211–221. doi:10.1007/s12687-011-0058-9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vargas, V., & Poblete, S. (2008). Health prioritization: the case of Chile. Health Aff (Millwood), 27(3), 782–792. doi:10.1377/hlthaff.27.3.782.

    Article  Google Scholar 

  • Weitzel, J. N., Lagos, V., Blazer, K. R., Nelson, R., Ricker, C., Herzog, J., et al. (2005). Prevalence of BRCA mutations and founder effect in high-risk Hispanic families. Cancer Epidemiology, Biomarkers & Prevention, 14(7), 1666–1671. doi:10.1158/1055-9965.EPI-05-0072.

    Article  CAS  Google Scholar 

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Acknowledgements

This work was supported by grant number U54CA096297 and grant number 1U54CA163071-01A1. Furthermore, we want to thank the support of the Puerto Rico Clinical and Translational Research Consortium (8U54MD007587-03).

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Correspondence to Marcia Cruz-Correa.

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Cruz-Correa, M., Pérez-Mayoral, J., Dutil, J. et al. Clinical Cancer Genetics Disparities among Latinos. J Genet Counsel 26, 379–386 (2017). https://doi.org/10.1007/s10897-016-0051-x

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