title: Migrant breast cancer patients and their participation in genetic counseling: results from a registry-based study.
abstract: Certain ethnic groups seem to have less access to cancer genetic counseling. Our study was to investigate the participation in cancer genetic counseling among migrant breast cancer patients of Turkish and Moroccan origin. Hospital medical records of Turkish and Moroccan and of a comparative group of non-Turkish/Moroccan newly diagnosed breast cancer patients were studied. All women were diagnosed between 2007 and 2012. Eligibility for genetic counseling was assessed with a checklist. A total of 156 Turkish/Moroccan patients were identified, and 321 patients were assigned to the comparative group. About one third (35%) of the Turkish/Moroccan patients fulfilled criteria for breast cancer genetic counseling, compared to 21% of the comparative group (P = 0.001); this was largely due to a relatively young age at diagnosis in the migrant group (26% <40 years vs 5% in the comparative group, P = 0.0001). Uptake of genetic counseling among eligible patients was 47% in the migrant group and 56% in the comparative group; differences in uptake were seen among the patients diagnosed before 40 years of age (48% in the migrant group vs 81% in the comparative group; P = 0.021). When adjusted for age at diagnosis, ethnicity was associated with discussing referral to genetic counseling and its actual uptake. The Turkish/Moroccan ethnicity appears to be associated with a lower uptake of genetic counseling, mainly caused by the lower uptake in the young age-group. The major barrier to participation in genetic counseling seems to lie within the referral process.
authors.affiliation: Division of Biomedical Genetics, Department of Medical Genetics, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands.
authors.forename: J E
authors.initials: JE
authors.lastname: Baars
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.|Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.|Faculty of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway.
authors.forename: A M
authors.initials: AM
authors.lastname: van Dulmen
authors.affiliation: Division of Biomedical Genetics, Department of Medical Genetics, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands.
authors.forename: M E
authors.initials: ME
authors.lastname: Velthuizen
authors.affiliation: Division of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: E B M
authors.initials: EB
authors.lastname: Theunissen
authors.affiliation: Division of Surgery, St. Lucas Andreas Hospital, Amsterdam, The Netherlands.
authors.forename: B C
authors.initials: BC
authors.lastname: Vrouenraets
authors.affiliation: Division of Surgery, Slotervaart Hospital, Amsterdam, The Netherlands.
authors.forename: A N
authors.initials: AN
authors.lastname: Kimmings
authors.affiliation: Division of Surgery, Diakonessen Hospital, Utrecht, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: van Dalen
authors.affiliation: Division of Surgery, Meander Medical Center, Amersfoort, The Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: van Ooijen
authors.affiliation: Division of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: A J
authors.initials: AJ
authors.lastname: Witkamp
authors.affiliation: Comprehensive Cancer Centre the Netherlands (IKNL), Utrecht, The Netherlands.
authors.forename: M A
authors.initials: MA
authors.lastname: van der Aa
authors.affiliation: Division of Biomedical Genetics, Department of Medical Genetics, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands. M.G.E.M.Ausems@umcutrecht.nl.
authors.forename: M G E M
authors.initials: MG
authors.lastname: Ausems
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology / Q000235:genetics* / Q000473:pathology; D005260:Female; D005817:Genetic Counseling / Q000706:statistics & numerical data*; D005820:Genetic Testing / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009426:Netherlands / Q000208:ethnology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012042:Registries; D012959:Socioeconomic Factors; D014171:Transients and Migrants / Q000706:statistics & numerical data*
keywords: Breast; Cancer; Genetic testing; Moroccan; Oncology; Turkish
references.citation: Asian Pac J Cancer Prev. 2014;15(3):1067-74
references.pmid: 24606420
references.citation: J Clin Oncol. 2006 May 10;24(14):2197-203
references.pmid: 16682739
references.citation: Asian Pac J Cancer Prev. 2011;12(9):2317-22
references.pmid: 22296377
references.citation: Am J Med Genet A. 2003 Mar 1;117A(2):154-60
references.pmid: 12567413
references.citation: Br J Cancer. 2014 Feb 18;110(4):1081-7
references.pmid: 24423928
references.citation: Breast J. 2009 Sep-Oct;15 Suppl 1:S56-62
references.pmid: 19775331
references.citation: Eur J Cancer. 2010 Sep;46(14):2647-59
references.pmid: 20843493
references.citation: Cancer Invest. 2006 Aug-Sep;24(5):484-91
references.pmid: 16939956
references.citation: J Gen Intern Med. 2004 Mar;19(3):273-80
references.pmid: 15009784
references.citation: Genet Med. 2011 Apr;13(4):349-55
references.pmid: 21358336
references.citation: Palliat Support Care. 2013 Feb;11(1):69-78
references.pmid: 23171758
references.citation: J Genet Couns. 2015 Feb;24(1):134-48
references.pmid: 25120034
references.citation: Ethn Health. 2009 Jun;14(3):237-53
references.pmid: 19012066
references.citation: J Community Genet. 2012 Oct;3(4):265-74
references.pmid: 22426886
references.citation: Cancer Epidemiol. 2009 Dec;33(6):413-8
references.pmid: 19900846
references.citation: World J Surg Oncol. 2009 Apr 08;7:37
references.pmid: 19356229
references.citation: Trop Med Int Health. 2001 Aug;6(8):654-61
references.pmid: 11555431
references.citation: Clin Genet. 2001 Nov;60(5):323-30
references.pmid: 11903329
references.citation: Cancer. 2009 May 15;115(10):2222-33
references.pmid: 19241424
references.citation: J Natl Compr Canc Netw. 2009 Nov;7(10):1060-96
references.pmid: 19930975
references.citation: Breast Cancer Res Treat. 2010 Dec;124(3):643-51
references.pmid: 20204502
references.citation: Gesundheitswesen. 2006 Oct;68(10):643-9
references.pmid: 17099826
references.citation: JAMA. 2005 Apr 13;293(14):1729-36
references.pmid: 15827311
references.citation: Int J Gen Med. 2013 Jun 05;6:439-45
references.pmid: 23785239
references.citation: Acta Oncol. 2013 Aug;52(6):1195-201
references.pmid: 23193960
references.citation: Gynecol Oncol. 2012 Jun;125(3):687-92
references.pmid: 22425665
references.citation: J Clin Oncol. 2010 May 10;28(14):2404-10
references.pmid: 20368571
references.citation: J Clin Oncol. 2009 Dec 10;27(35):5887-92
references.pmid: 19858402
references.citation: Oncol Lett. 2011 Mar;2(2):389-393
references.pmid: 22866093
references.citation: Int J Med Sci. 2013;10(1):60-7
references.pmid: 23289006