Wayne State University School of Medicine, Detroit, Michigan, USA.
Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA.
Cancer Med. 2022 Sep;11(17):3304-3311. doi: 10.1002/cam4.4684. Epub 2022 Mar 23.
The study was conducted to evaluate racial differences in referral and uptake of genetic counseling (GC) in a clinic-based population of women with breast cancer.
Medical records of 150 breast cancer patients at the Karmanos Cancer Institute were reviewed to determine eligibility for GC according to National Comprehensive Cancer Network guidelines, GC referral rates, and appointment completion rates. Logistic regression was used to assess the relationship between demographic and clinical factors and GC eligibility and referral.
The mean age at diagnosis was 57.1 (SD 12.6) and 66% of the women were Black. There were 91 women (60.7%) eligible for GC and of those, 54 (61.4%) were referred. After multivariable analyses, factors associated with reduced eligibility were older age at diagnosis (OR = 0.91, 95% CI [0.87,0.95]) and Black race (OR = 0.37, 95% CI [0.15, 0.96]). After additional multivariable analysis, eligibility was associated with an increased likelihood of referral (OR = 5.97, 95% CI [2.29, 15.56]), however, Medicare versus private insurance was associated with a lower likelihood for referral (OR = 0.32, 95% CI [0.12-0.80]. Of those referred, 49 (76.6%) completed an appointment, and 47 had genetic testing. Women with Medicare were also less likely to complete an appointment. Race had no impact on referral or appointment completion.
There were no racial differences in GC referral or appointment completion in a clinic-based sample of women with breast cancer. Further interventions are needed to promote increased referral and appointment completion for women with breast cancer who are eligible for GC.
本研究旨在评估基于诊所的乳腺癌患者群体中，遗传咨询（GC）转介和接受情况的种族差异。
对卡曼诺癌症研究所的 150 名乳腺癌患者的病历进行回顾，以根据国家综合癌症网络指南确定 GC 的资格、GC 转介率和预约完成率。使用逻辑回归评估人口统计学和临床因素与 GC 资格和转介的关系。
诊断时的平均年龄为 57.1（SD 12.6），66%的女性为黑人。有 91 名女性（60.7%）有资格接受 GC，其中 54 名（61.4%）被转介。多变量分析后，与 GC 资格降低相关的因素包括诊断时年龄较大（OR=0.91，95%CI [0.87,0.95]）和黑人种族（OR=0.37，95%CI [0.15,0.96]）。在进一步的多变量分析后，GC 资格与增加转介的可能性相关（OR=5.97，95%CI [2.29,15.56]），然而，医疗保险与私人保险相比，转介的可能性较低（OR=0.32，95%CI [0.12-0.80]）。在被转介的患者中，有 49 名（76.6%）完成了预约，有 47 名接受了基因检测。医疗保险的女性也不太可能完成预约。种族对转介或预约完成没有影响。
在基于诊所的乳腺癌女性样本中，GC 转介或预约完成没有种族差异。需要进一步干预，以促进对有资格接受 GC 的乳腺癌女性增加转介和预约完成。
