Provider discussion of genetic counseling among high-risk Spanish-preferring Latina breast cancer survivors

Abstract

Among high-risk breast cancer (BC) survivors, genetic counseling (GC) and genetic testing (GT) may inform cascade testing and risk management. Compared to non-Hispanic White BC survivors, Spanish-preferring Latina BC survivors are less likely to report discussing GC with a healthcare provider. However, few studies have examined Latinas’ experiences with GC/GT, particularly outside of the mainland USA. This study aimed to compare frequency of provider discussion of GC between Spanish-preferring Latina BC survivors living in Florida (FL) and Puerto Rico (PR). We conducted secondary data analysis of baseline assessments from a randomized pilot of an educational intervention for Spanish-preferring Latina BC survivors. Participants (N = 52) were GC/GT-naive, but met clinical criteria for GC/GT referral. Participants self-reported sociodemographic, clinical, and cultural variables, including previous provider discussion of GC. Descriptive statistics characterized frequency of GC discussion. Logistic regression examined the relationships between sociodemographic, clinical, and cultural characteristics and GC discussion. Only 31% of participants reported previous GC discussion. More participants from PR reported having GC discussions (43% vs. 21% in the mainland USA). In multivariable analyses, greater likelihood of GC discussion was associated with PR (vs. mainland USA) residence (odds ratio [OR] = 6.00, p = .03), older age at baseline (OR = 1.19, p = .04), and younger age at BC diagnosis (OR = 0.80, p = .03). Few high-risk Spanish-preferring Latina BC survivors in the mainland USA and PR had discussed GC with their providers. These results highlight a gap in the implementation of evidence-based genetics guidelines. Provider-directed interventions may be needed to increase uptake of GC/GT among Latina BC survivors.

Behavioral beliefs about genetic counseling among high‐risk Latina breast cancer survivors in Florida and Puerto Rico

“…Although participants in our study endorsed benefits of GC, similar to prior studies they wanted more GC information 11 . Participants' reported lack of adequate information about GC is consistent with previous publications from the parent study, where it was documented that at baseline participants had limited knowledge about GC 14 and only one third of the participants reported prior provider discussion about GC 17 . In this study, FL participants more often endorsed GC reduction in cancer worry compared to PR participants, suggesting that Latinas in PR might benefit from further information and clarification about GC, especially on post‐GC decrease in cancer worry 18 .…”