Abstract A41: Does medical mistrust influence black women's participating in BRCA1/2 genetic counseling and testing?

Abstract

Abstract Approximately 5%-10% of breast cancers are heritable. Clinical evidence supports the value of BRCA1/2 genetic counseling and testing (GC/T) for hereditary breast and ovarian cancer risk. However, BRCA1/2 GC/T is underutilized among Black women and reasons are not well understood. We examined the potential influence of medical mistrust on GC/T participation in a sample of 100 Black women at increased risk for carrying a BRCA1/2 mutation. Eligible participants fell into one of three groups: 1) healthy women with > 1 first-degree relative (FDR) affected by breast and/or ovarian cancer, 2) women diagnosed with breast cancer at < 50 years of age, and 3) women diagnosed with breast and/or ovarian cancer at > 50 years of age with either one FDR or two second degree relatives with breast and/or ovarian cancer. Participants were recruited from hospital and community settings and completed a researcher-administered survey. The dependent variable indicated women's GC/T participation (0 = unaware, 1=aware but had no referral, and; 2 = received a referral and/or GC/T). Medical Mistrust was assessed using the 7-item Medical Mistrust Index (Cronbach's α ≥ 0.70) Bivariate tests and multivariate regression analyses were employed. GC/T participation was only 28%. After accounting for sociodemographic factors and self-efficacy (B = 0.37, p < .001), multivariate analysis revealed that women with higher medical mistrust had lower GC/T participation (B = −0.26, p <.01). Interventions to improve utilization of GC/T in Black women at increased risk should incorporate strategies to enhance their personal confidence and address women's concerns about the medical system. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A41.