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

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Cooperative Studies Program Epidemiology Center-Durham, Durham Veterans Affairs Health Care System, 508 Fulton Street, Durham, NC, 27705, USA

    Christina D. Williams, Alyssa Jasmine Bullard, Meghan O’Leary, Reana Thomas & Thomas S. Redding IV

  2. Department of Medicine, Division of Medical Oncology, Duke University, Durham, NC, USA

    Christina D. Williams

  3. Center for Health Services Research in Primary Care, Durham Veterans Affairs Health Care System, 508 Fulton Street, Durham, NC, 27705, USA

    Karen Goldstein

  4. Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, 411 West Chapel Hill Street, Suite 500, Durham, NC, 27701, USA

    Karen Goldstein

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  1. Christina D. Williams
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Correspondence to Christina D. Williams.

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Williams, C.D., Bullard, A.J., O’Leary, M. et al. Racial/Ethnic Disparities in BRCA Counseling and Testing: a Narrative Review. J. Racial and Ethnic Health Disparities 6, 570–583 (2019). https://doi.org/10.1007/s40615-018-00556-7

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  • DOI: https://doi.org/10.1007/s40615-018-00556-7

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