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Health Care Disparities in Hereditary Ovarian Cancer: Are We Reaching the Underserved Population?

  • Thomas C. RandallEmail author
  • Katrina Armstrong
Gynecologic Cancers (RJ Morgan, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Gynecologic Cancers

Opinion Statement

Ovarian cancer is an uncommon but deadly disease. There is no effective screening for the disease, and the majority of women with ovarian cancer present in advanced stage and eventually die from their disease. The majority of families with multiple cases of breast and ovarian cancer are found to carry germline mutations in BRCA1/2. Recent, more sensitive sequencing techniques have shown that nearly 20 % of ovarian cancer is associated with germline mutations in cancer susceptibility genes, with approximately 15 % accounted for by deleterious mutations in BRCA1/2. Women found to have mutations in BRCA1/2 can be empowered to make decisions on reproduction, cancer prevention, or treatment that may either avoid cancer or prolong survival. Though initial studies suggested that African American (AA) women were significantly less likely than White women to have mutations in BRCA1/2, this has been found to be untrue. Despite this revelation, and the clear importance of BRCA1/2 mutation status to appropriate clinical management, AA women still undergo genetic counseling and testing at much lower rates than do comparable White women. This disparity is not explained by factors such as calculated risk of a mutation, insurance coverage, or previous knowledge of the availability of testing. To date, no effective strategies have been identified that can overcome this disparity. Possible approaches include use of patient navigators, online social media, or EMR-based decision support aids. Funders should support research in this area, as it represents an actionable means to decrease the burden of ovarian and breast cancer in AA women.

Keywords

BRCA1/2 Hereditary ovarian cancer Disparities Genetic counseling 

Notes

Compliance with Ethical Standards

Conflict of Interest

Thomas C. Randall declares that he has no conflict of interest.

Katrina Armstrong is a member of an Advisory Committee for GlaxoSmithKline.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Obsterics and GynecologyThe Massachusetts General HospitalBostonUSA
  2. 2.Department of MedicineThe Massachusetts General HospitalBostonUSA

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