Latinas' knowledge of and experiences with genetic cancer risk assessment: Barriers and facilitators.

Gómez-Trillos S1,2, Sheppard VB3, Graves KD1,2, Song M1, Anderson L4, Ostrove N5, Lopez K1, Campos C6, Gonzalez N7, Hurtado-de-Mendoza A1,2.

Author information

1: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, District of Columbia.
2: The Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Washington, District of Columbia.
3: Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
4: Department of Nursing, California State University, Sacramento, California.
5: EXPRE, LLC, Gaithersburg, Maryland.
6: Nueva Vida DC Office, Alexandria, Virginia.
7: Capital Breast Cancer Center, Washington, District of Columbia.

Abstract

Disparities in genetic cancer risk assessment (GCRA) uptake persist between Latinas and Non-Hispanic Whites. This study utilized a mental model approach to interview 20 Latinas (10 affected, 10 unaffected) at increased risk for hereditary breast and ovarian cancer (HBOC). Participants were asked about their knowledge and perceptions of GCRA, HBOC, risk, benefits, motivators, barriers, challenges, and experiences with GCRA. Using the Consensual Qualitative Analysis Framework, two authors independently coded the interviews and applied the final codes upon consensus. Additionally, interviews were coded to identify whether participants spontaneously brought up certain topics without a prompt. Findings identified multiple barriers and facilitators to GCRA uptake in this population, including patient level psychosocial/cultural factors (e.g., limited knowledge, worry about relatives' risk) and healthcare system factors (e.g., receiving no referrals). There were notable differences in awareness and knowledge between affected and unaffected women (e.g., genetic testing awareness), as well as knowledge gaps that were evident in both groups (e.g., age of diagnosis as a risk factor). To reduce disparities in GCRA uptake, interventions should address identified facilitators and barriers. Differences in knowledge and awareness between affected and unaffected women support the development of targeted interventions that address specific knowledge gaps. This study was registered in ClinicalTrials.gov (NCT03075540) by Alejandra Hurtado de Mendoza, Ph.D.

KEYWORDS:

HBOC; Hispanic; Latina; attitudes; barriers; disparities; disparity; experiences; facilitators; genetic counseling; genetic testing; knowledge; perceptions; underrepresented populations