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    Genetic Evaluation for Breast Cancer Susceptibility In Hispanic and Non-Hispanic White Women In South Texas

    Scientific Abstract:
    Genetic Evaluation for Breast Cancer Susceptibility in Hispanic and Non-Hispanic White Women in South Texas. Background: Studies have shown that Hispanic women with breast cancer present with more advanced disease and have poorer survival rates compared with non-Hispanic white women. Objective/Hypothesis: Identify the (1) prevalence of perceived benefits, perceived risks/limitations, interest, and willingness to undergo breast cancer genetic testing; (2) proportion of women who actually undergo counseling and testing; (3) predictive factors for patients’ perceived benefits/risks, interest, and willingness to undergo breast cancer genetic evaluation; and (4) differences with regard to predictive factors when comparing Hispanic and non-Hispanic white women. We hypothesize that women who reject counseling will report more barriers to genetic testing and score lower on scales measuring breast cancer genetics knowledge than those who accept both counseling and testing. Specific Aims: (1) Identify the predictors of perceived benefits, risks, and limitations of breast cancer genetic testing in Hispanic and non-Hispanic white women; (2) define the prevalence of knowledge/awareness of breast cancer genetics – genes, breast cancer genes, genetic testing – in Hispanic and non-Hispanic white women; (3) characterize the proportion of women undergoing genetic evaluation; (4) define factors influencing decisions in breast cancer counseling and testing among Hispanic and non-Hispanic white women; and (5) contrast factors influencing Hispanic women with those affecting decisions in non-Hispanic white women. Study Design: 300 participants aged 30 or older (150 Hispanic and 150 non-Hispanic white) will be given a pretested, culturally sensitive survey to collect data regarding breast cancer knowledge, attitudes, and behaviors. Participants will be categorized into three groups according to risk of genetic breast cancer susceptibility: no cancer risk, low/moderate risk, and high risk. All participants will be given the survey. Eligible high-risk participants will be offered genetic counseling and testing. Potential Outcomes and Benefits of Research: Completion of survey, genetic counseling, and genetic testing. We will correlate factors regarding knowledge, attitudes, and behavior, with decisions in breast cancer counseling and testing between Hispanic and non-Hispanic white women. Results will help guide development of culturally sensitive interventions and programs that would help Hispanic and non-Hispanic women make more informed decisions about genetic testing.

    Lay Abstract:
    Genetic Evaluation for Breast Cancer Susceptibility in Hispanic and Non-Hispanic White Women in South Texas. Research has shown that Hispanic women with breast cancer tend to be diagnosed at more advanced stages of the disease and have poorer survival rates when compared with non-Hispanic white women. Women who receive counseling may improve their survival rates, especially among those who suffer most from cancer health disparities. In this study, 300 women (150 Hispanic and 150 non-Hispanic white) aged 30 or older will be recruited to complete a pretested, culturally sensitive survey that examines breast cancer knowledge, attitudes, and behaviors. Participants will be divided into three groups according to their level of genetic breast cancer risk: no cancer risk, low/moderate risk, and high risk. Only high-risk participants will receive genetic counseling. Examples of women at high risk include those with breast cancer at an early age (before the age of 50), or those with multiple family members with breast and/or ovarian cancer. After the genetic counseling session, those individuals who meet the criteria for genetic testing will be offered testing. The study will compare differences between Hispanic and non-Hispanic white women concerning 1) awareness, perceived benefits, and risk of breast cancer genetic testing; 2) characteristics of the women undergoing genetic evaluation; and 3) factors associated with decisions to accept or decline breast cancer counseling and testing. We believe that women who reject counseling will report having more barriers to genetic testing and be less informed about breast cancer genetics than those who accept both counseling and testing. The outcomes to be measured will be the completion of surveys, genetic counseling sessions, and genetic testing. The study’s results will be published and used in the development of culturally sensitive interventions and materials that will improve informed decision making for breast cancer counseling and testing Hispanic and non-Hispanic women.