Increased uptake of BRCA1/2 genetic testing among African American women with a recent diagnosis of breast cancer.
OBJECTIVE
Studies suggest that African American women are less likely to pursue BRCA1/2 genetic testing than white women. However, such studies are often confounded by unequal access to care.


METHODS
Data from 132 African American and 636 white women, obtained from a clinical database at the University of North Carolina (Chapel Hill, NC) between 1998 and 2005, were analyzed to assess BRCA1/2 genetic testing uptake. Importantly, the clinical setting minimized barriers of both cost and access. Race and time of new breast cancer diagnosis (recent v > 1 year before genetic evaluation) were assessed for association with BRCA1/2 testing uptake using multivariable logistic regression models.


RESULTS
Both race (P = .0082) and a recent diagnosis of breast cancer (P = .014) were independently associated with testing uptake. African American women had a lower estimated odds of pursuing testing than white women (odds ratio [OR], 0.54; 95%CI, 0.34 to 0.85), and women with a recent diagnosis had a higher OR than those with a remote diagnosis (OR, 1.58; 95% CI, 1.10 to 2.29). In a race-stratified analysis, there was no statistical evidence for association between recent status and testing uptake in the larger white stratum (OR, 1.38, P = .13) while there was for the smaller African American sample (OR, 2.77, P = .018). The test of interaction between race and remote status was not significant (P = .15).


CONCLUSIONS
African American race was associated with an overall decreased uptake of BRCA1/2 genetic testing, even when barriers of ascertainment and cost were minimized. However, among African American women, a recent diagnosis of breast cancer was associated with substantially increased uptake of testing.
Susswein
Lisa R
LR
Department of Genetics, and Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7264, USA.
Skrzynia
Cécile
C
Lange
Leslie A
LA
Booker
Jessica K
JK
Graham
Mark L
ML
Evans
James P
JP
D000328:Adult; D001741:Black or African American / Q000235:genetics*; D001294:Attitude to Health / Q000208:ethnology; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000208:ethnology* / Q000235:genetics*; D016022:Case-Control Studies; D005260:Female; D005817:Genetic Counseling; D005820:Genetic Testing; D006801:Humans; D008875:Middle Aged; D009154:Mutation; D012307:Risk Factors; D012959:Socioeconomic Factors; D044465:White People / Q000235:genetics
D019313:BRCA1 Protein; D024682:BRCA2 Protein