Hereditary cancer panel testing challenges and solutions for the latinx community: costs, access, and variants View Full Text


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Article Info

DATE

2021-11-06

AUTHORS

Michael P. Douglas, Grace A. Lin, Julia R. Trosman, Kathryn A. Phillips

ABSTRACT

Hereditary breast and ovarian cancers (HBOCs) are common among the Latinx population, and risk testing is recommended using multi-gene hereditary cancer panels (HCPs). However, little is known about how payer reimbursement and out-of-pocket expenses impact provider ordering of HCP in the Latinx population. Our objective is to describe key challenges and possible solutions for HCP testing in the Latinx population. As part of a larger study, we conducted semi-structured interviews with key provider informants (genetic counselors, oncologist, nurse practitioner) from safety-net institutions in the San Francisco Bay Area. We used a deductive thematic analysis approach to summarize themes around challenges and possible solutions to facilitating HCP testing in Latinx patients. We found few financial barriers for HCP testing for the Latinx population due to laboratory patient assistance programs that cover testing at low or no cost to patients. However, we found potential challenges related to the sustainability of low-cost testing and out-of-pocket expenses for patients, access to cascade testing for family members, and pathogenic variants specific to Latinx. Providers questioned whether current laboratory payment programs that decrease barriers to testing are sustainable and suggested solutions for accessing cascade testing and ensuring variants specific to the Latinx population were included in testing. The use of laboratories with payment assistance programs reduces barriers to HCP testing among the US population; however, other barriers are present that may impact testing use in the Latinx population and must be addressed to ensure equitable access to HCP testing for this population. More... »

PAGES

75-80

References to SciGraph publications

  • 2019-12-31. Exome sequencing reveals a high prevalence of BRCA1 and BRCA2 founder variants in a diverse population-based biobank in GENOME MEDICINE
  • 2020-02-24. Prevalence of mutations in a diverse cohort of 3162 women tested via the same multigene cancer panel in a managed care health plan in JOURNAL OF COMMUNITY GENETICS
  • 2010-01-07. Exploring attitudes, beliefs, and communication preferences of Latino community members regarding BRCA1/2 mutation testing and preventive strategies in GENETICS IN MEDICINE
  • 2019-05-18. Developing a culturally targeted video to enhance the use of genetic counseling in Latina women at increased risk for hereditary breast and ovarian cancer in JOURNAL OF COMMUNITY GENETICS
  • 2015-11-12. The spectrum of BRCA1 and BRCA2 alleles in Latin America and the Caribbean: a clinical perspective in BREAST CANCER RESEARCH AND TREATMENT
  • 2011-07-12. A pilot study of knowledge and interest of genetic counseling and testing for hereditary breast and ovarian cancer syndrome among Puerto Rican women in JOURNAL OF COMMUNITY GENETICS
  • 2021-05-06. Laboratory business models and practices: implications for availability and access to germline genetic testing in GENETICS IN MEDICINE
  • 2016-12-12. Clinical Cancer Genetics Disparities among Latinos in JOURNAL OF GENETIC COUNSELING
  • 2010-08-27. Awareness, Perceptions, and Provider Recommendation Related to Genetic Testing for Hereditary Breast Cancer Risk among At-Risk Hispanic Women: Similarities and Variations by Sub-Ethnicity in JOURNAL OF GENETIC COUNSELING
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    URI

    http://scigraph.springernature.com/pub.10.1007/s12687-021-00563-y

    DOI

    http://dx.doi.org/10.1007/s12687-021-00563-y

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34743282


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