Breast cancer is the leading cause of cancer death for Latinas in the U.S., according to the American Cancer Society. Genetic epidemiologic research conducted by Jeffrey Weitzel, M.D., director of the Division of Clinical Cancer Genetics at City of Hope, a leading research and treatment center for cancer and other life-threatening diseases, has shown that certain mutations in the BRCA genes are prevalent among immigrant Latinas ? women of Latin American and/or Spanish descent ? with breast or ovarian cancer, similar to the frequency of mutations in Ashkenazi Jewish women. BRCA1 and BRCA2 are genes that belong to a class of genes known as tumor suppressors, and mutation of these genes has been linked to hereditary breast and ovarian cancer. Genetic risk assessment can determine if a woman has these mutations and is at increased risk for developing these cancers.
To evaluate whether culturally sensitive outreach and education can improve participation in genetic counseling for cancer risk among Latinas, Weitzel received a five-year, $1.9 million grant from the American Cancer Society (ACS). He leads the study, in collaboration with Los Angeles County+USC Medical Center and Olive View-UCLA Medical Center.
?We are seeing a greater proportion of Latina women diagnosed with late-stage breast cancer compared to white women, but when genetic cancer risk assessments are made available, we see less than half of Latinas show for their initial appointment,? Weitzel said.
Through genetic counseling, women learn about their heredity and personal cancer risk factors and receive support from professionals on how to manage that risk, such as preventive surgery, medications or more frequent screenings.
In previous work funded by the Komen Foundation for the Cure, Weitzel and his colleagues looked at a wide variety of factors that influence whether Latinas participate in genetic cancer risk counseling services and then follow up by getting screenings and take steps to reduce their risk. While the Latinas who received counseling then took appropriate action, Weitzel?s team found that many women passed up the potentially lifesaving consultation.
The team?s studies have shown that women find the waiting time before a genetic cancer risk assessment to be the most stressful, which might dissuade women from their first appointment. They tested whether a technique called adapted motivational interviewing in which women scheduled for genetic screening are contacted and counseled by phone in advance of their appointment could improve attendance at screenings.?We found that 88% of patients who received the phone call attended their screening appointment,? said Weitzel.
Based on the findings, Weitzel and his colleagues will expand the concept and use the American Cancer Society grant to evaluate whether a phone intervention that is culturally appropriate can improve appointment adherence, prescreening anxiety and cancer genetics knowledge.
The American Cancer Society estimates more than 207,000 women will be diagnosed with breast cancer this year, and nearly 40,000 will die from the disease.
