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Anxiety and depression among racial/ethnic minorities and impoverished women testing positive for BRCA1/2 mutations in the United States

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Abstract

Purpose

To outline the association between race/ethnicity and poverty status and perceived anxiety and depressive symptomologies among BRCA1/2-positive United States (US) women to identify high-risk groups of mutation carriers from medically underserved backgrounds.

Methods

A total of 211 BRCA1/2-positive women from medically underserved backgrounds were recruited through national Facebook support groups and completed an online survey. Adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression for associations between race/ethnicity, poverty status, and self-reported moderate-to-severe anxiety and depressive symptoms.

Results

Women ranged in age (18–75, M = 39.5, SD = 10.6). Most women were non-Hispanic white (NHW) (67.2%) and were not impoverished (76.7%). Hispanic women with BRCA1/2 mutations were 6.11 times more likely to report moderate-to-severe anxiety (95% CI, 2.16–17.2, p = 0.001) and 4.28 times more likely to report moderate-to-severe depressive symptoms (95% CI, 1.98–9.60, p < 0.001) than NHW women with these mutations. Associations were not statistically significant among other minority women. Women living in poverty were significantly less likely to report moderate-to-severe depressive symptoms than women not in poverty (aOR, 0.42, 95% CI, 0.18–0.95, p = 0.04).

Conclusion

Hispanic women with BRCA1/2 mutations from medically underserved backgrounds are an important population at increased risk for worse anxiety and depressive symptomology. Our findings among Hispanic women with BRCA1/2 mutations add to the growing body of literature focused on ethnic disparities experienced across the cancer control continuum.

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Data Availability

The datasets generated during and/or analyzed the current study are available at the Principal Investigator’s (PI) discretion upon reasonable request.

Code availability

Syntax coding is available upon reasonable request from the corresponding author.

Abbreviations

aOR:

Adjusted odds ratio

BRCA:

BReast CAncer gene mutation

CI:

Confidence interval

MRI:

Magnetic resonance imaging

NHW:

Non-Hispanic white

US:

United States

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Acknowledgements

We would like to acknowledge the women who shared their experiences with us.

Funding

This work was supported by the Johns Hopkins Ho-Ching Wang Memorial Faculty Award. Kate E Dibble received research support from the National Cancer Institute (T32CA009314) Cancer Epidemiology, Prevention, and Control training program.

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Authors and Affiliations

  1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA

    Kate E. Dibble & Avonne E. Connor

  2. Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21205, USA

    Avonne E. Connor

Authors
  1. Kate E. Dibble
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Contributions

Kate E Dibble conceptualized and designed the study, was in charge of data acquisition, data analysis, and interpretation. Kate E Dibble also wrote the main manuscript text and revised the article, as well as approving the final version. Avonne E Connor assisted with study conceptualization and design, data interpretation, as well as drafting and finalizing the manuscript.

Corresponding author

Correspondence to Kate E. Dibble.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Johns Hopkins Bloomberg School of Public Health Institutional Review Board (IRB#00013710).

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Informed consent was obtained from all individual participants included in the study.

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Not applicable.

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The authors declare no competing interests.

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Dibble, K.E., Connor, A.E. Anxiety and depression among racial/ethnic minorities and impoverished women testing positive for BRCA1/2 mutations in the United States. Support Care Cancer 30, 5769–5778 (2022). https://doi.org/10.1007/s00520-022-07004-7

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