title: Concerns about cancer risk and experiences with genetic testing in a diverse population of patients with breast cancer.
abstract: OBJECTIVE
  To evaluate preferences for and experiences with genetic testing in a diverse cohort of patients with breast cancer identified through population-based registries, with attention to differences by race/ethnicity.
  
  
  METHODS
  We surveyed women diagnosed with nonmetastatic breast cancer from 2005 to 2007, as reported to the SEER registries of metropolitan Los Angeles and Detroit, about experiences with hereditary risk evaluation. Multivariable models evaluated correlates of a strong desire for genetic testing, unmet need for discussion with a health care professional, and receipt of testing.
  
  
  RESULTS
  Among 1,536 patients who completed the survey, 35% expressed strong desire for genetic testing, 28% reported discussing testing with a health care professional, and 19% reported test receipt. Strong desire for testing was more common in younger women, Latinas, and those with family history. Minority patients were significantly more likely to have unmet need for discussion (failure to discuss genetic testing with a health professional when they had a strong desire for testing): odds ratios of 1.68, 2.44, and 7.39 for blacks, English-speaking Latinas, and Spanish-speaking Latinas compared with whites, respectively. Worry in the long-term survivorship period was higher among those with unmet need for discussion (48.7% v 24.9%; P <.001). Patients who received genetic testing were younger, less likely to be black, and more likely to have a family cancer history.
  
  
  CONCLUSIONS
  Many patients, especially minorities, express a strong desire for genetic testing and may benefit from discussion to clarify risks. Clinicians should discuss genetic risk even with patients they perceive to be at low risk, as this may reduce worry.
authors.affiliation: Reshma Jagsi, Center for Bioethics and Social Science in Medicine, University of Michigan; Kent A. Griffith, Center for Biostatistics, School of Public Health, University of Michigan; Steven J. Katz, University of Michigan; Sarah T. Hawley, Ann Arbor VA Health Care System, University of Michigan, Ann Arbor, MI; Allison W. Kurian, Stanford University School of Medicine, Stanford; Ann S. Hamilton, Keck School of Medicine, University of Southern California, Los Angeles, CA; Monica Morrow, Memorial Sloan-Kettering Cancer Center, New York, NY; and John J. Graff, Rutgers University, New Brunswick, NJ. rjagsi@med.umich.edu.
authors.forename: Reshma
authors.initials: R
authors.lastname: Jagsi
authors.affiliation: Reshma Jagsi, Center for Bioethics and Social Science in Medicine, University of Michigan; Kent A. Griffith, Center for Biostatistics, School of Public Health, University of Michigan; Steven J. Katz, University of Michigan; Sarah T. Hawley, Ann Arbor VA Health Care System, University of Michigan, Ann Arbor, MI; Allison W. Kurian, Stanford University School of Medicine, Stanford; Ann S. Hamilton, Keck School of Medicine, University of Southern California, Los Angeles, CA; Monica Morrow, Memorial Sloan-Kettering Cancer Center, New York, NY; and John J. Graff, Rutgers University, New Brunswick, NJ.
authors.forename: Kent A
authors.initials: KA
authors.lastname: Griffith
authors.affiliation: Reshma Jagsi, Center for Bioethics and Social Science in Medicine, University of Michigan; Kent A. Griffith, Center for Biostatistics, School of Public Health, University of Michigan; Steven J. Katz, University of Michigan; Sarah T. Hawley, Ann Arbor VA Health Care System, University of Michigan, Ann Arbor, MI; Allison W. Kurian, Stanford University School of Medicine, Stanford; Ann S. Hamilton, Keck School of Medicine, University of Southern California, Los Angeles, CA; Monica Morrow, Memorial Sloan-Kettering Cancer Center, New York, NY; and John J. Graff, Rutgers University, New Brunswick, NJ.
authors.forename: Allison W
authors.initials: AW
authors.lastname: Kurian
authors.affiliation: Reshma Jagsi, Center for Bioethics and Social Science in Medicine, University of Michigan; Kent A. Griffith, Center for Biostatistics, School of Public Health, University of Michigan; Steven J. Katz, University of Michigan; Sarah T. Hawley, Ann Arbor VA Health Care System, University of Michigan, Ann Arbor, MI; Allison W. Kurian, Stanford University School of Medicine, Stanford; Ann S. Hamilton, Keck School of Medicine, University of Southern California, Los Angeles, CA; Monica Morrow, Memorial Sloan-Kettering Cancer Center, New York, NY; and John J. Graff, Rutgers University, New Brunswick, NJ.
authors.forename: Monica
authors.initials: M
authors.lastname: Morrow
authors.affiliation: Reshma Jagsi, Center for Bioethics and Social Science in Medicine, University of Michigan; Kent A. Griffith, Center for Biostatistics, School of Public Health, University of Michigan; Steven J. Katz, University of Michigan; Sarah T. Hawley, Ann Arbor VA Health Care System, University of Michigan, Ann Arbor, MI; Allison W. Kurian, Stanford University School of Medicine, Stanford; Ann S. Hamilton, Keck School of Medicine, University of Southern California, Los Angeles, CA; Monica Morrow, Memorial Sloan-Kettering Cancer Center, New York, NY; and John J. Graff, Rutgers University, New Brunswick, NJ.
authors.forename: Ann S
authors.initials: AS
authors.lastname: Hamilton
authors.affiliation: Reshma Jagsi, Center for Bioethics and Social Science in Medicine, University of Michigan; Kent A. Griffith, Center for Biostatistics, School of Public Health, University of Michigan; Steven J. Katz, University of Michigan; Sarah T. Hawley, Ann Arbor VA Health Care System, University of Michigan, Ann Arbor, MI; Allison W. Kurian, Stanford University School of Medicine, Stanford; Ann S. Hamilton, Keck School of Medicine, University of Southern California, Los Angeles, CA; Monica Morrow, Memorial Sloan-Kettering Cancer Center, New York, NY; and John J. Graff, Rutgers University, New Brunswick, NJ.
authors.forename: John J
authors.initials: JJ
authors.lastname: Graff
authors.affiliation: Reshma Jagsi, Center for Bioethics and Social Science in Medicine, University of Michigan; Kent A. Griffith, Center for Biostatistics, School of Public Health, University of Michigan; Steven J. Katz, University of Michigan; Sarah T. Hawley, Ann Arbor VA Health Care System, University of Michigan, Ann Arbor, MI; Allison W. Kurian, Stanford University School of Medicine, Stanford; Ann S. Hamilton, Keck School of Medicine, University of Southern California, Los Angeles, CA; Monica Morrow, Memorial Sloan-Kettering Cancer Center, New York, NY; and John J. Graff, Rutgers University, New Brunswick, NJ.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Katz
authors.affiliation: Reshma Jagsi, Center for Bioethics and Social Science in Medicine, University of Michigan; Kent A. Griffith, Center for Biostatistics, School of Public Health, University of Michigan; Steven J. Katz, University of Michigan; Sarah T. Hawley, Ann Arbor VA Health Care System, University of Michigan, Ann Arbor, MI; Allison W. Kurian, Stanford University School of Medicine, Stanford; Ann S. Hamilton, Keck School of Medicine, University of Southern California, Los Angeles, CA; Monica Morrow, Memorial Sloan-Kettering Cancer Center, New York, NY; and John J. Graff, Rutgers University, New Brunswick, NJ.
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Hawley
mesh_terms: D000328:Adult; D001741:Black or African American / Q000235:genetics / Q000523:psychology / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000235:genetics*; D003142:Communication; D005190:Family; D005260:Female; D005820:Genetic Testing; D006282:Health Personnel; D006630:Hispanic or Latino / Q000235:genetics / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D018426:SEER Program; D011795:Surveys and Questionnaires; D014481:United States; D044465:White People / Q000235:genetics / Q000523:psychology / Q000706:statistics & numerical data*
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