Abstract P3-12-13: Evaluation of disparities in anxiety, depression, and cancer empowerment in a study of BRCA1/2-positive females in the United States
Authors: Dibble Kate E , Connor Avonne E 
Published: March 2022

Abstract
Introduction. Individuals testing positive for the BRCA1 and/or BRCA2 (BReast CAncer) mutations are 33-55% more likely to develop breast and/or ovarian cancers before the age of 70. Prognoses and rates of recurrence for these individuals have been found to be significantly worse than breast/ovarian cancer patients without these mutations. The constant risk of cancer and uncertainty, in combination with ongoing surveillance and prophylactic risk-reduction surgeries, for living with these mutations may lead to adverse mental health effects. The current analyses aim to determine whether race, ethnicity, and economic disparity predict higher anxiety, depression, and cancer-related empowerment among BRCA1/2-positive women. Methods. The study population includes 225 women with BRCA1/2 genetic mutations recruited from online, private Facebook support groups. All participants were screened for inclusion criteria and identified with at least one disadvantaged health group (racial, ethnic, or sexual minority, Ashkenazi Jewish heritage, person with physical disability, chronically ill, those in poverty, immigrant populations). Participants completed an online survey collecting demographic, clinical cancer and genetic testing information, and standardized scales to measure anxiety, depressive symptoms, and cancer empowerment. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression models for the associations between race, ethnicity, and poverty status and three outcomes: 1) anxiety (moderate/severe, mild [referent]); 2) depression (moderate/moderately severe/severe, minimal/mild [referent]); 3) cancer empowerment (above average, below average [referent]). Final models were adjusted for age at interview, marital status, education, employment status, survivor/control status, number of comorbidities, family history of breast/ovarian cancers, and years since genetic testing. Results. A total of 208 women with (n=70, 34.6%) and without (n=138, 65.4%) a history of breast or ovarian cancer with an average age of 39.5 years (SD=10.6) completed the online survey. Most of the study participants self-reported being non-Hispanic white (NHW) (80.2%) and 23.0% reported living in poverty status. All reported at least one chronic illness (most commonly depression [31.3%] and obesity [25.6%]). Hispanic women had 4.99 the odds of moderate/severe anxiety (95% CI: 1.40-17.7; p=.013) and 3.52 the odds of moderate/moderately severe/severe depression symptomology (95% CI: 1.12-11.0; p=.031) than NHW women. Race and poverty status did not significantly predict worse anxiety or depressive symptoms. Associations with cancer empowerment were not statistically significant. Conclusion. While previous studies have shown that increased anxiety and depression are reported among BRCA1/2-positive women, our study found higher odds of depression and anxiety among Hispanic women when compared to NHW women. These findings infer the need for mental health care interventions with this minority population to improve psychosocial health, Future research among BRCA1/2-positive women should consider focusing recruitment on enrolling women from disparate backgrounds such as racial and ethnic minorities, to further understand how these symptoms may be improved with consideration of preventive cancer and survivorship care.
Citation Format: Kate E Dibble, Avonne E Connor. Evaluation of disparities in anxiety, depression, and cancer empowerment in a study of BRCA1/2-positive females in the United States [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-12-13.