Racial Disparities in BRCA-Related Management Strategies

Fewer black BRCA carriers undergo salpingo-oophorectomy to reduce their risk for breast cancer than their Hispanic and non-Hispanic white counterparts.
Fewer black BRCA carriers undergo salpingo-oophorectomy to reduce their risk for breast cancer than their Hispanic and non-Hispanic white counterparts.

Fewer black BRCA carriers undergo salpingo-oophorectomy to reduce their risk for breast cancer than their Hispanic and non-Hispanic white counterparts, according to a study published in the journal Cancer.1

Although previous research has demonstrated disparities in the screening and treatment of breast cancer, limited data on disparities with respect to BRCA mutations are available. Therefore, researchers sought to compare disparities in provider discussions, receipt of genetic testing, and cancer risk-management practices among BRCA carriers who are non-Hispanic white, black, and Hispanic breast cancer survivors.

For the study, investigators enrolled 1622 women with invasive breast cancer diagnosed at age 50 years or younger and who had undergone BRCA testing. Of those, 36.1% were black, 64.5% were non-Hispanic white, 49.6% were Spanish-speaking Hispanic women, and 69% were English-speaking Hispanic women. Approximately 5.5% had a pathogenic BRCA mutation identified.

After adjusting for multiple variables, results showed that significantly fewer black BRCA carriers underwent risk-reducing mastectomy and risk-reducing salpingo-oophorectomy compared with Hispanic and non-Hispanic white BRCA carriers (P =.025 and P =.008, respectively).

The authors note that these results are particularly concerning because benefits from genetic testing are derived from cancer risk-management strategies.

Investigators also found that black women were 16 times less likely to participate in discussions of genetic testing with a provider than non-Hispanic white women. Spanish-speaking Hispanic women were nearly half as likely to have those discussions as non-Hispanic white women.

The findings suggest that additional strategies are needed to prevent the widening of disparities among BRCA carriers to ultimately reduce the risk of breast cancer across all populations.

Reference

1. Cragun D, Weidner A, Lewis C, et al. Racial disparities in BRCA testing and cancer risk management across a population-based sample of young breast cancer survivors. Cancer. 2017 Feb 9. doi: 10.1002/cncr.30621 [Epub ahead of print]
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