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Racial/Ethnic Disparities in BRCA Counseling and Testing: a Narrative Review

  • Christina D. WilliamsEmail author
  • Alyssa Jasmine Bullard
  • Meghan O’Leary
  • Reana Thomas
  • Thomas S. ReddingIV
  • Karen Goldstein
Article

Abstract

Background/objective

Despite increases in BRCA mutation testing, racial/ethnic disparities in counseling and testing have persisted for decades. The purpose of the review was to summarize recent literature as it relates to detecting, understanding, and reducing disparities in BRCA counseling and testing.

Design

This is a narrative review of articles published January 2012 to July 2017 relevant to genetic testing and counseling, breast and ovarian cancer, and minority health and heath disparities. Twenty-three articles were included in this review.

Results

Studies report lower counseling and/or testing rates for eligible racial/ethnic minorities among family members of high-risk individuals as well as among breast cancer survivors. Key barriers and facilitators of disparate BRCA counseling/testing that emerged in this review included awareness, cost-related factors, stress and distrust, family concerns and communication, and provider communication and referral. To address differential access to and use of BRCA testing services and expand testing in minority populations, it is necessary for interventions to focus on improving awareness, risk-perception, and family and patient-provider communication.

Conclusion

Multi-level and targeted interventions are needed to reduce persistent racial/ethnic disparities and improve assessment, provider recommendations, counseling and testing among minority populations.

Keywords

Breast cancer Health care disparities Hereditary cancer syndrome Genetic testing Genetic counseling 

Notes

Compliance with Ethical Standards

This article does not contain any studies with human participants performed by any of the authors.

Conflicts of Interest

The authors declare that they have no conflicts of interest.

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Copyright information

© This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection 2019

Authors and Affiliations

  1. 1.Cooperative Studies Program Epidemiology Center-DurhamDurham Veterans Affairs Health Care SystemDurhamUSA
  2. 2.Department of Medicine, Division of Medical OncologyDuke UniversityDurhamUSA
  3. 3.Center for Health Services Research in Primary CareDurham Veterans Affairs Health Care SystemDurhamUSA
  4. 4.Department of Medicine, Division of General Internal MedicineDuke University Medical CenterDurhamUSA

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