Abstract B102: Impact of previous genetic counseling and reaction to genetic test results among Hispanic/Latino colorectal cancer patients in ENLACE: A cancer Moonshot study
Authors: Gutierrez Natalia , Mendez Joel Sanchez , Culver Julie O. , Ricker Charite R. , Chavez Carmen , Enriquez Lucia , Algaze Sandra , Carpten John D. , Lenz Heinz-Josef , Stern Mariana C. 
Published: September 2024

Background: Inequities in access to genetic testing exist among Hispanic/Latino (H/L) individuals, a population disproportionately affected by colorectal cancer (CRC) burden. Past studies demonstrate the value of genetic counseling (GC) on improving patient understanding of genetic testing utility, but few studies have focused on H/L individuals. Therefore, we assessed the impact of having prior-GC on genetic testing knowledge among patients enrolled in the ENLACE study, a NCI-Moonshot-funded study of participant engagement in genomic characterization among H/L CRC patients. Methods: The ENLACE study enrolled participants from two healthcare facilities since 2022: Los Angeles General Medical Center (LA Gen, a safety-net hospital) and USC Norris Comprehensive Cancer Center (Norris, a university medical center). Baseline surveys to assess sociodemographic characteristics, genetic literacy and comprehension (GLAC), and genetic knowledge (KnowGene) were evaluated. Following somatic and germline return-of-results (ROR), Feelings About genomiC Testing Results (FACToR) for germline sequencing, the impact of somatic testing on cancer patient knowledge, attitudes, and expectations, and Decisional Regret for genomics research participation were evaluated. Results: A total of 105 H/L CRC participants completed surveys at baseline, and 39 post ROR. Most were recruited at LA Gen (n = 72), are male (n = 56), and Mexico-born (n = 55). Fifty participants (33, LA Gen; 17, Norris) had GC prior to study enrollment. No difference was found in the sociodemographic characteristics of participants with prior-GC by facility (p = 0.24). When stratified by prior-GC and facility there were no differences in GLAC and KnowGene scores, using univariate analysis (all p-values &gt; 0.05). Post-ROR total FACToR score, which ranges from 0-48 with higher scores indicating greater functional impairment, was low with a median of 11 (IQR = 5.0-23.0) and no differences were seen for prior-GC or without (p = 0.2). Participants had low decisional regret with a median score of 2.5 (IQR = 0-25.0), on a 0-100 scale. When examining opinions about genetic testing in cancer care, 84% (n = 33) of patients agreed or strongly agreed that genetic testing based on today’s technology would significantly improve their cancer treatment and care. Conclusion: There was no association with prior-GC and baseline genetic knowledge scores. Post-ROR, the cohort had low functional impairment and decisional regret from genetic testing, suggesting that these H/L patients have a favorable reaction to their genetic test results. A limitation of this evaluation is that it does not consider the effect of GC during ROR, completed for some patients, on post-ROR responses. As the study progresses, larger numbers will allow us to stratify by germline test results and dosage of GC. These findings support the need for impactful genetics education tools and communication methods to ensure greater understanding of genetics for H/L individuals to maximize genetic testing utility.

Citation Format: Natalia Gutierrez, Joel Sanchez Mendez, Julie O. Culver, Charite R. Ricker, Carmen Chavez, Lucia Enriquez, Sandra Algaze, John D. Carpten, Heinz-Josef Lenz, Mariana C. Stern. Impact of previous genetic counseling and reaction to genetic test results among Hispanic/Latino colorectal cancer patients in ENLACE: A cancer Moonshot study [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B102.