Why do we screen who we screen? BRCA mutation genetic risks and guidelines for Latina and African-American women

Issues: This project is an advocacy plan for increased awareness of genetic risks of ovarian and breast cancer posed by BRCA1 and BRCA2 genes (breast cancer 1&2, early onset) in Latina and African-American women in the United States. Cancer outcome disparities exist for these minority groups. They are less likely than Caucasian women to be aware of the role of BRCAmutations in cancer, and less likely to have access to screening services.

Description: A systematic review of the literature was performed to identify health disparities by ethnicity in BRCAmutation awareness and screening. Current policies contributing to the disparities were examined, including the absence of U.S. Preventative Services Task Force (USPSTF) recommendations for at-risk minority screening beyond Ashkenazi women. A program to address disparities in health was designed.

Lessons Learned: Advancements in genetic screening are contributing to health disparities through differential access, awareness, and availability. The complexity of the topic adds additional barriers for women of low education. This care gap will widen if not addressed in the early stages of widespread use of genetic screening.

Recommendations: The advocacy program will be implemented in clinics that serve low-income communities. Health care providers will be made aware of the necessity of BRCA genetic testing education across ethnic groups. The goal will be to reduce mortality of minority women due to BRCA mutation-related cancers through more inclusive and better targeted screening. Suggested policy changes include USPSTF screening guidelines emphasizing the particular risks posed to Latina and African-American women.