Henderson Vida, Strayhorn Shaila M, Bergeron Nyahne Q, Strahan Desmona C, Ganschow Pamela S, Khanna Aditya S, Watson Karriem, Hoskins Kent, Molina Yamile
Fred Hutchinson Cancer Research Center, Public Health Sciences Division, Seattle, WA, USA.
14681Community Health Sciences Division, University of Illinois Chicago, Chicago, IL, USA.
Cancer Control. 2022 Jan-Dec;29:10732748221104666. doi: 10.1177/10732748221104666.
Despite the benefits of genetic counseling and testing (GCT), utilization is particularly low among African American (AA) women who exhibit breast cancer features that are common in BRCA-associated cancer. Underutilization is especially problematic for AA women who are more likely to die from breast cancer than women from any other race or ethnicity. Due to medical mistrust, fear, and stigma that can be associated with genetic services among racial/ethnic minorities, reliance on trusted social networks may be an impactful strategy to increase dissemination of knowledge about hereditary cancer risk. Informed by the social cognitive theory, the purpose of this study is to determine: 1) which AA patients diagnosed with breast cancer and with identified hereditary risk are sharing information about hereditary risk with their networks; 2) the nature of the information dissemination; and 3) if personal GCT experiences is associated with dissemination of information about hereditary risk.
Among consented participants (n = 100) that completed an interview administered using a 202-item questionnaire consisting of open- and closed-ended questions, 62 patients were identified to be at higher risk for breast cancer. Descriptive statistics, bivariable chi-square, Pearson's exact tests, and regression analyses were conducted to examine differences in characteristics between high-risk participants who disseminated hereditary risk information and participants who did not.
Among high-risk participants, 25 (40%) indicated they had disseminated information about hereditary risk to at least one member in their family/friend network and 37 (60%) had not. Receipt of both provider recommendations and receipt of GCT services was associated with greater odds of disseminating information about hereditary risk with networks, OR = 4.53, 95%CI [1.33, 15.50], p = .02.
Interventions that increase self-efficacy gained through additional personalized knowledge and experience gained through provider recommendations and by undergoing GCT may facilitate information dissemination among social/familial networks.
尽管基因咨询与检测（GCT）有诸多益处，但在具有BRCA相关癌症常见乳腺癌特征的非裔美国（AA）女性中，其利用率特别低。对于比其他任何种族或族裔的女性更易死于乳腺癌的AA女性而言，利用不足尤其成问题。由于种族/族裔少数群体中可能与基因服务相关的医疗不信任、恐惧和污名，依赖可信赖的社交网络可能是增加遗传性癌症风险知识传播的有效策略。基于社会认知理论，本研究的目的是确定：1）哪些被诊断患有乳腺癌且已确定存在遗传风险的AA患者正在与其社交网络分享遗传风险信息；2）信息传播的性质；3）个人的GCT经历是否与遗传风险信息的传播相关。
在同意参与的100名参与者中，他们完成了一项使用包含开放式和封闭式问题的202项问卷进行的访谈，其中62名患者被确定为乳腺癌高风险患者。进行了描述性统计、双变量卡方检验、Pearson精确检验和回归分析，以检查传播遗传风险信息的高风险参与者与未传播者之间的特征差异。
在高风险参与者中，25名（40%）表示他们已向其家庭/朋友网络中的至少一名成员传播了遗传风险信息，37名（60%）未传播。接受提供者建议和接受GCT服务均与向社交网络传播遗传风险信息的几率更高相关，OR = 4.53，95%CI [1.33, 15.50]，p = 0.02。
通过提供者建议和接受GCT获得的额外个性化知识和经验提高自我效能的干预措施，可能会促进社交/家庭网络中的信息传播。
