Cultural aspects of cancer genetics: setting a research agenda.
BACKGROUND
Anecdotal evidence suggests that people from non-Anglo-Celtic backgrounds are under-represented at familial cancer clinics in the UK, the USA, and Australia. This article discusses cultural beliefs as a potential key barrier to access, reviews previous empirical research on cultural aspects of cancer genetics, draws implications from findings, and sets a research agenda on the inter-relationships between culture, cancer genetics, and kinship.


METHODS
The CD-ROM databases MEDLINE, PsychLIT, CINAHL, and Sociological Abstracts were searched from 1980 onwards.


RESULTS
Cultural aspects of cancer genetics is the focus of an emerging body of publications. Almost all studies assessed African-American women with a family history of breast cancer and few studies included more diverse samples, such as Americans of Ashkenazi Jewish background or Hawaiian- and Japanese-Americans. Our analysis of published reports suggests several directions for future research. First, an increased focus on various Asian societies appears warranted. Research outside North America could explore the extent to which findings can be replicated in other multicultural settings. In addition, control group designs are likely to benefit from systematically assessing culture based beliefs and cultural identity in the "majority culture" group used for comparative purposes.


CONCLUSIONS
More data on which to base the provision of culturally appropriate familial cancer clinic services to ethnically diverse societies are needed. Empirical data will assist with culturally appropriate categorisation of people from other cultures into risk groups based on their family histories and provide the basis for the development of culturally appropriate patient education strategies and materials.
Meiser
B
B
Department of Psychological Medicine, Block 4, Level 5, Royal North Shore Hospital, St Leonards, NSW 2065, Sydney, Australia. b.meiser@unsw.edu.au
Eisenbruch
M
M
Barlow-Stewart
K
K
Tucker
K
K
Steel
Z
Z
Goldstein
D
D
D001741:Black or African American; D044466:Asian People / Q000235:genetics; D001315:Australia; D044383:Black People; D018864:Cultural Diversity; D019992:Databases as Topic; D030541:Databases, Genetic; D004522:Educational Status; D005006:Ethnicity / Q000235:genetics*; D005192:Family Health; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005820:Genetic Testing / Q000706:statistics & numerical data; D006266:Health Education / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D007585:Jews / Q000235:genetics; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000235:genetics*; D044469:Racial Groups / Q000235:genetics*; D012107:Research Design / Q000592:standards; D006113:United Kingdom; D014481:United States