Abstract PO-049: Evaluation of disparities in genetic testing-related outcomes among BRCA1/2-positive women: Impact of race/ethnicity and residential locale
Authors: Dibble Kate E , Connor Avonne E. 
Published: January 2022

Abstract
Individuals who test positive for BRCA1/2 genes, or hereditary breast cancer mutations, are 33-55% more likely to develop breast and ovarian cancers before the age of 70. While research on hereditary genetic testing for these mutations continues to emerge, there remains unanswered questions regarding access to testing and related cancer care. The purpose of this study is to determine the associations between race/ethnicity, residential locale, and several genetic testing-related outcomes among women with BRCA1/2 mutations. This study is a cross-sectional study of US-based women (18+ years) who have tested positive for either (or both) BRCA1/2 genetic mutations within the past 5 years and who identify with one or more disadvantaged health population (racial, ethnic, or sexual minority, person with a physical disability, chronically-ill, those in poverty, immigrant populations). Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression models for the associations between race/ethnicity (non-Hispanic white [referent], minority status), locale (urban [referent], suburban, rural), and genetic testing outcomes (i.e. specific genetic mutation, behavioral/family therapy referral post-testing, receiving family-based genetic testing, genetic testing through a primary care provider (PCP) or direct-to-consumer (DTC) [vs. genetic counseling office or hospital genetics program], and undergoing surgery or surveillance). A total of 211 women were recruited from Facebook BRCA1/2-oriented support groups to complete an online survey measuring demographic, cancer, and genetic information, psychosocial variables, access to care, experiences with genetic testing, and suggestions for future care and 194 were included in the current analysis. Most participants were NHW (67.2%), employed full- or part-time (81.5%), and lived in a suburban locale (56.4%). Women living in suburban areas were significantly less likely (aOR=.394, 95% CI, .191-.816) to receive behavioral/family therapy referrals after genetic testing compared to those living in an urban locale. Women living within a rural locale were 3.39 times more likely to receive genetic testing from a PCP or DTC (95% CI, 1.15-9.91) compared to women living in urban locales. No significant results were observed for adjusted models with race/ethnicity as the predictor or with other genetic testing outcomes. Our study identifies disparities in genetic testing resources and access among women living in suburban and rural areas of the US. These findings can be used to inform future care, research, and resources that may impact services relating to genetic testing within these locales.
Citation Format: Kate E Dibble, Avonne E. Connor. Evaluation of disparities in genetic testing-related outcomes among BRCA1/2-positive women: Impact of race/ethnicity and residential locale [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-049.