Disparities in BRCA counseling across providers in a diverse population of young breast cancer survivors
Menée aux Etats-Unis à partir de données de registres portant sur 1 622 patientes atteintes d'un cancer du sein invasif diagnostiqué entre 2009 et 2012, cette étude analyse les facteurs associés à l'accès aux tests et aux conseils génétiques pour les femmes de moins de 50 ans ayant survécu à la maladie
Purpose: All women diagnosed with breast cancer (BC) ≤age 50 should be referred for genetic counseling (GC) and testing. We sought to compare differences in provider practices and access across a racially and ethnically diverse population of young BC survivors.
Methods: A registry-based sample of women diagnosed with invasive BC ≤age 50 from 2009 to 2012 was recruited through the Florida Cancer Registry, and completed a questionnaire and medical record release. Differences were compared across those tested with or without the involvement of a board-certified or credentialed genetics health professional (GHP) in (1) clinical and demographic variables and (2) pretest GC elements.
Results: Of 1622 participants, there were 440 Blacks, 285 Hispanics, and 897 Non-Hispanic Whites. Of 831 participants with medical record verification of testing provider, 170 (20%) had documentation of GHP involvement. Among the 613 who recalled a pretest discussion and had GC elements collected, those with GHP involvement were significantly more likely to recall the seven recognized GC elements.
Conclusion: GHP involvement was associated with adherence to nationally recommended best practices. With the expanding importance of identifying inherited cancers, it is critical to ensure equitable access to best practices across all populations.
Genetics in Medicine , résumé, 2020