The influence of acculturation and breast cancer‐specific distress on perceived barriers to genetic testing for breast cancer among women of African descent

Abstract

Objective-Rising health disparities are increasingly evident in relation to use of genetic services (including genetic counseling and testing) for breast cancer risk, with women of African descent less likely to use genetic services compared with Whites. Meanwhile, little is known regarding potential within-group acculturation and psychological differences underlying perceived barriers to genetic testing among women of African descent.Methods-Hypothesized contributions of acculturation factors and breast cancer-specific distress to perceived barriers to genetic testing were examined with a statistical analysis of baseline data from 146 women of African descent (56% US born and 44% foreign born) meeting genetic breast cancer risk criteria and participating in a larger longitudinal study that included the opportunity for free genetic counseling and testing. Perceived barriers assessed included: (1) anticipation of negative emotional reactions, (2) stigma, (3) confidentiality concerns, (4) family-related worry, and (5) familyrelated guilt associated with genetic testing.Results-In multivariate analyses, being foreign born was a significant predictor of anticipated negative emotional reactions about genetic testing (β= 0.26; SE=0.11; p = 0.01). Breast cancerspecific distress scores (avoidance symptoms) were positively related to anticipated negative emotional reactions (β = 0.02; SE= 0.005; p = <0.0001), confidentiality concerns (β = 0.02; SE = 0.01; p = 0.02), and family-related guilt (β = 0.02; SE=0.01; p = 0.0009) associated with genetic testing.Conclusions-Results suggest an influence of acculturation and breast cancer-specific distress on perceived barriers to genetic testing among women of African descent. The potential utility of culturally tailored genetic counseling services taking into account such influences and addressing

Addressing cancer control needs of African-born immigrants in the US: A systematic literature review

“…Ten studies, all conducted in the US, examined breast cancer, either exclusively 24,33,34 or along with other types of cancers. 32,35 Six were quantitative 23,24,32,34,36,37 and four used qualitative methods.…”

“…32,35 Six were quantitative 23,24,32,34,36,37 and four used qualitative methods. 33,35,38,39 Paper foci included breast cancer prevention 34 and detection, including barriers to genetic testing 24 and barriers to mammography screening. 23,32,37,3833,35 …”

“…However, only 3% of the sample was Africa-born and no specific findings were reported for African immigrants. In relation to quantitative studies focused on detection, Sussner and colleagues 24 found that foreign-born women of African descent anticipated having greater negative emotional reactions to genetic testing than US born women from African descent. Nevertheless, African immigrant women were underrepresented (89% were Caribbean), and no specific results for the African born population were described.…”

Factors associated with an individuals’ decision to withdraw from genetic counseling for BRCA1 and BRCA2 genes mutations: are personality traits involved?

“…Alternatively, with regard to educational level, women with higher levels of education were more likely to continue genetic counseling [14,16], even if, an American study reported that women with high school qualifications were less interested in counseling [17].…”

“…While, other studies instead have reported that psychological distress (particularly cancer-specific distress, that is anxiety and depression associated with worrying about cancer) was significantly associated with the refusal or the withdrawal from genetic counseling, whether levels were high or low. A moderate level of distress (general distress and cancer-specific distress) was found to facilitate the decision to undergo genetic counseling [16,[19][20][21][22].…”