Provider discussion of genetic counseling among high-risk Spanish-preferring Latina breast cancer survivors. Issue 9 (7th October 2022)

• Record Type: Journal Article
• Authors: Conley, Claire C; Rivera Rivera, Jessica N; Castro-Figueroa, Eida M; Moreno, Laura; Dutil, Julie; García, Jennifer D; Ricker, Charité; Quinn, Gwendolyn P; Soliman, Hatem; Vadaparampil, Susan T
• Is Part Of: Translational behavioral medicine. Volume 12:Issue 9(2022)
• Page Start: 900
• Page End: 908
• Publication Date: 2022-10-07
• Subjects: Breast cancer -- Genetic counseling -- Genetic testing -- Healthcare provider -- Hispanic -- Latina; Medicine and psychology -- Periodicals; 616.0019
• DOI: 10.1093/tbm/ibac031
• Languages: English
• ISSNs: 1869-6716

Abstract

Abstract: Among high-risk breast cancer (BC) survivors, genetic counseling (GC) and genetic testing (GT) may inform cascade testing and risk management. Compared to non-Hispanic White BC survivors, Spanish-preferring Latina BC survivors are less likely to report discussing GC with a healthcare provider. However, few studies have examined Latinas' experiences with GC/GT, particularly outside of the mainland USA. This study aimed to compare frequency of provider discussion of GC between Spanish-preferring Latina BC survivors living in Florida (FL) and Puerto Rico (PR). We conducted secondary data analysis of baseline assessments from a randomized pilot of an educational intervention for Spanish-preferring Latina BC survivors. Participants ( N = 52) were GC/GT-naive, but met clinical criteria for GC/GT referral. Participants self-reported sociodemographic, clinical, and cultural variables, including previous provider discussion of GC. Descriptive statistics characterized frequency of GC discussion. Logistic regression examined the relationships between sociodemographic, clinical, and cultural characteristics and GC discussion. Only 31% of participants reported previous GC discussion. More participants from PR reported having GC discussions (43% vs. 21% in the mainland USA). In multivariable analyses, greater likelihood of GC discussion was associated with PR (vs. mainland USA) residence (odds ratio [OR] = 6.00, p = .03), older age at baseline (OR = 1.19, p = .04), and younger age at BC diagnosis (OR = 0.80, p = .03). Few high-risk Spanish-preferring Latina BC survivors in the mainland USA and PR had discussed GC with their providers. These results highlight a gap in the implementation of evidence-based genetics guidelines. Provider-directed interventions may be needed to increase uptake of GC/GT among Latina BC survivors. Lay Summary: Some families have changes in the BRCA genes that increase their risk for developing breast cancer compared to those who do not have these gene changes. Through genetic testing, we can identify breast cancer survivors who have these gene changes so their families can take action to prevent future cancers. Breast cancer survivors who are diagnosed at a young age, or who have a strong family history of breast and ovarian cancer, are eligible for genetic counseling and BRCA testing. Yet, compared to women from other racial and ethnic groups, fewer Latina breast cancer survivors have genetic counseling and testing. This study explored frequency of healthcare providers' discussion about genetic counseling among Spanish-preferring Latina breast cancer survivors living in Florida and Puerto Rico. Although all participants were eligible, only 3 out of 10 indicated that a provider previously discussed genetic counseling with them. Participants who were living in Puerto Rico, older at study entry, or younger at the time of their breast cancer diagnosis were more likely to have discussed genetic counseling with a healthcare provider. Healthcare providers are important for identifying and referring high-risk Spanish-preferring Latinas for genetic counseling in and outside the mainland USA. Abstract : Although they were all eligible for genetic counseling, few Spanish-preferring Latina breast cancer survivors had previously discussed genetic counseling with a healthcare provider. Graphical Abstract: