Vadaparampil Susan T, Wideroff Louise, Breen Nancy, Trapido Edward
Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida College of Medicine, Tampa, USA.
Cancer Epidemiol Biomarkers Prev. 2006 Apr;15(4):618-23. doi: 10.1158/1055-9965.EPI-05-0378.
Previous studies suggest disparities in use of preventive cancer services among U.S. Hispanics are partly explained by knowledge and access factors. One area of emerging interest is uptake of genetic counseling and testing services by underserved populations. This study aims to estimate the percentage of Hispanics in five ethnic subgroups who are aware of genetic testing for inherited cancer risk, and to assess the influence of acculturation factors primarily related to language on test awareness. Weighted data from 4,313 Hispanic respondents (age >25 years) in the year 2000 National Health Interview Survey were analyzed. Overall, 20.6% of Hispanics had heard of genetic testing for cancer risk, with percentages highest among Puerto Ricans (27.3%) and lowest among Mexicans (14.3%). Completing the interview in Spanish and English [odds ratio (OR), 0.52; 95% confidence interval (95% CI), 0.35-0.78], or only Spanish (OR, 0.60; 95% CI, 0.42-0.86), was inversely associated with test awareness (reference group, only English). Having an intermediate (OR, 0.66; 95% CI, 0.48-0.90) or low (OR, 0.63; 95% CI, 0.39-1.01) level of English language preference was also inversely associated (reference, high level) whereas being born outside the United States was weakly associated (OR, 0.80; 95% CI, 0.57-1.11). Estimates were adjusted for age, education, ethnicity, parents' cancer history, health care access, and selected health behaviors and beliefs. Results of this national survey indicate that acculturation factors related to language may affect cancer genetic test awareness in Hispanics. These factors must be taken into account when informing individuals about the role of genetics in cancer risk and providing cancer genetic health services.
以往研究表明，美国西班牙裔人群在预防性癌症服务利用方面的差异部分可由知识和获取因素来解释。一个新出现的关注领域是服务不足人群对遗传咨询和检测服务的接受情况。本研究旨在估计五个族裔亚组中知晓遗传性癌症风险基因检测的西班牙裔人群的比例，并评估主要与语言相关的文化适应因素对检测知晓情况的影响。对2000年全国健康访谈调查中4313名西班牙裔受访者（年龄>25岁）的加权数据进行了分析。总体而言，20.6%的西班牙裔听说过癌症风险基因检测，其中波多黎各人的比例最高（27.3%），墨西哥人最低（14.3%）。用西班牙语和英语完成访谈（优势比[OR]，0.52；95%置信区间[95%CI]，0.35 - 0.78），或仅用西班牙语（OR，0.60；95%CI，0.42 - 0.86），与检测知晓情况呈负相关（参照组为仅用英语）。英语语言偏好处于中等（OR，0.66；95%CI，0.48 - 0.90）或低等（OR，0.63；95%CI，0.39 - 1.01）水平也呈负相关（参照为高等水平），而在美国境外出生的关联较弱（OR，0.80；95%CI，0.57 - 1.11）。估计值针对年龄、教育程度、族裔、父母癌症病史、医疗保健获取情况以及选定的健康行为和信念进行了调整。这项全国性调查结果表明，与语言相关的文化适应因素可能会影响西班牙裔人群对癌症基因检测的知晓情况。在向个体告知基因在癌症风险中的作用以及提供癌症基因健康服务时，必须考虑这些因素。
