Black women in the US less likely to access preventative cancer treatments

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A report from the University of Pennsylvania School of Medicine in Philadelphia says that black women in the US with a family history of breast or ovarian cancer, are far less likely to seek genetic counselling and possible testing than their white counterparts, and although the reasons for the disparity are not clear, it is suspected that mistrust of both the medical system and advice from primary physicians may be factors.

The report looked at 408 women with a family history of breast or ovarian cancers and found that black women in the group were 78 percent less likely to undergo genetic counselling than white women and the disparity could not be attributed to income, cancer risk perception and worry, or attitudes about such testing. The report did find that on the whole black women appeared to visit a "a relatively small proportion" of US physicians who are less likely to be board certified and who are "more likely to report difficulty delivering high quality care." They were also more distrusting of the health care system than whites, and that may serve "as a barrier to use of medical care."

Counselling can help women with a family history of breast or ovarian cancer decide if they should be tested to learn whether they, or their children, are in a high-risk group. If so, testing looks at the BRCA1 or BRCA2 genes where mutations have been shown to increase risk of breast or ovarian cancer. Detecting mutations helps women decide if they need protective surgery, drugs or additional screening, or if their daughters are also likely at risk. This testing has only been around since 1996 and mutations are relatively rare and the risk information may not be precise.

The report found evidence that African American women underestimate their risk of breast cancer and are less aware of genetic testing technology as a means of assessing personal risk.

In an editorial commenting on the study, researchers at the University of Chicago said: "Clearly, access to preventive medical care in the United States is by no means equally distributed."

The report is published in the current edition of the Journal of the American Medical Association.

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