title: Ethnic, racial and cultural identity and perceived benefits and barriers related to genetic testing for breast cancer among at-risk women of African descent in New York City.
abstract: BACKGROUND
  Due to disparities in the use of genetic services, there has been growing interest in examining beliefs and attitudes related to genetic testing for breast and/or ovarian cancer risk among women of African descent. However, to date, few studies have addressed critical cultural variations among this minority group and their influence on such beliefs and attitudes.
  
  
  METHODS
  We assessed ethnic, racial and cultural identity and examined their relationships with perceived benefits and barriers related to genetic testing for cancer risk in a sample of 160 women of African descent (49% self-identified African American, 39% Black-West Indian/Caribbean, 12% Black-Other) who met genetic risk criteria and were participating in a larger longitudinal study including the opportunity for free genetic counseling and testing in New York City. All participants completed the following previously validated measures: (a) the multi-group ethnic identity measure (including ethnic search and affirmation subscales) and other-group orientation for ethnic identity, (b) centrality to assess racial identity, and (c) Africentrism to measure cultural identity. Perceived benefits and barriers related to genetic testing included: (1) pros/advantages (including family-related pros), (2) cons/disadvantages (including family-related cons, stigma and confidentiality concerns), and (3) concerns about abuses of genetic testing.
  
  
  RESULTS
  In multivariate analyses, several ethnic identity elements showed significant, largely positive relationships to perceived benefits about genetic testing for breast and/or ovarian cancer risk, the exception being ethnic search, which was positively associated with cons/disadvantages, in general, and family-related cons/disadvantages. Racial identity (centrality) showed a significant association with confidentiality concerns. Cultural identity (Africentrism) was not related to perceived benefits and/or barriers.
  
  
  CONCLUSIONS
  Ethnic and racial identity may influence perceived benefits and barriers related to genetic testing for breast and/or ovarian cancer risk among at-risk women of African descent. Genetic counseling services may want to take into account these factors in the creation of culturally-appropriate services which best meet the needs of this heterogenous population.
authors.affiliation: Division of Cancer Prevention and Control, Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY 10029, USA. katarina.sussner@mssm.edu
authors.forename: K M
authors.initials: KM
authors.lastname: Sussner
authors.forename: T A
authors.initials: TA
authors.lastname: Edwards
authors.forename: H S
authors.initials: HS
authors.lastname: Thompson
authors.forename: L
authors.initials: L
authors.lastname: Jandorf
authors.forename: N O
authors.initials: NO
authors.lastname: Kwate
authors.forename: A
authors.initials: A
authors.lastname: Forman
authors.forename: K
authors.initials: K
authors.lastname: Brown
authors.forename: N
authors.initials: N
authors.lastname: Kapil-Pair
authors.forename: D H
authors.initials: DH
authors.lastname: Bovbjerg
authors.forename: M D
authors.initials: MD
authors.lastname: Schwartz
authors.forename: H B
authors.initials: HB
authors.lastname: Valdimarsdottir
mesh_terms: D001741:Black or African American; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics*; D017691:Caribbean Region; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D005006:Ethnicity; D005260:Female; D005817:Genetic Counseling; D005820:Genetic Testing / Q000379:methods*; D006801:Humans; D015999:Multivariate Analysis; D009519:New York City; D010051:Ovarian Neoplasms / Q000235:genetics; D010465:Perception; D012306:Risk