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Disparities in uptake of BRCA1/2 genetic testing in a randomized trial of telephone counseling.
- Source :
-
Genetics in medicine : official journal of the American College of Medical Genetics [Genet Med] 2015 Jun; Vol. 17 (6), pp. 467-75. Date of Electronic Publication: 2014 Sep 18. - Publication Year :
- 2015
-
Abstract
- Purpose: As genetic counseling and testing become more fully integrated into clinical care, alternative delivery models are increasingly prominent. This study examines predictors of genetic testing for hereditary breast/ovarian cancer among high-risk women in a randomized trial of in-person versus telephone-based genetic counseling.<br />Methods: Methods include multivariable logistic regression and interaction analyses.<br />Results: Of the 669 participants, 600 completed counseling and 523 received test results. As previously reported, participants randomized to telephone counseling were significantly less likely to be tested. In intention-to-treat analyses, completion of counseling and testing was associated with: race/ethnicity (odds ratio (OR) = 1.96, 95% confidence interval (CI): 1.20-3.20), perceived stress (OR = 0.89, 95% CI: 0.81-0.98), knowledge (OR = 1.12, 95% CI: 1.02-1.23), and randomization group (OR = 1.48, 95% CI: 1.01-2.16). Further, race/ethnicity moderated the association between randomization group and testing; minority women receiving telephone counseling were least likely to complete testing.<br />Conclusion: Evidence for logistical and communication-based explanations for this interaction is presented. The overall increased access made possible with telephone genetic counseling should be considered in light of the possibility that this may also lead to lower rates of testing among high-risk minority women. Additional care should be taken to assess and address potential barriers when services are delivered by telephone.Genet Med 17 6, 467-475.
- Subjects :
- Adult
Female
Hereditary Breast and Ovarian Cancer Syndrome diagnosis
Hereditary Breast and Ovarian Cancer Syndrome epidemiology
Hereditary Breast and Ovarian Cancer Syndrome genetics
Humans
Middle Aged
Odds Ratio
Risk Factors
Telephone
Genes, BRCA1
Genes, BRCA2
Genetic Counseling
Genetic Testing
Healthcare Disparities
Subjects
Details
- Language :
- English
- ISSN :
- 1530-0366
- Volume :
- 17
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Genetics in medicine : official journal of the American College of Medical Genetics
- Publication Type :
- Academic Journal
- Accession number :
- 25232856
- Full Text :
- https://doi.org/10.1038/gim.2014.125