Hispanic women with newly diagnosed breast cancer who qualify for genetic testing based on national guidelines are often not referred to genetic counseling at the same rate as non-Hispanics patients. The reasons for the lower referral and testing rate are not currently well understood. Often patients in a minority population face diverse barriers to accessing care, particularly care that requires specialized training, is expensive, and may not be completely covered by insurance. In our study, we sought to explore the rate of referral and testing of newly diagnosed breast cancer patients in a predominantly Hispanic population at UT Health Mays Cancer Center in San Antonio where more than 60% of patients are Hispanic. Included in this study were 153 sequential new patient referrals to the breast medical oncology clinic with the diagnosis of invasive carcinoma or ductal carcinoma in situ. Current NCCN guidelines for genetic testing were utilized. Data collected included age of diagnosis, current age, gender, race, ethnicity, preferred language, stage, family history of breast, ovarian, pancreatic, or prostate cancer. It was then determined if patients met criteria, if they were referred to genetic counselors, if they attended their appointment, and if they received genetic testing. The prevalence of Hispanic women meeting criteria for genetic testing was 63.9% compared with 61.7% of non-Hispanic women. Of the Hispanic women meeting criteria for genetic testing only 71.8% received testing. Our cancer center has many processes in place that would be expected to increase the rate of genetic testing for Hispanic patients. These include having Spanish speaking staff, a robust genetic counseling team, telemedicine visits, county programs that allow unfunded patients to access care at our cancer center, and grant funding from the state of Texas to cover the additional cost of testing for unfunded patients. Despite this, about 30% of Hispanic patients that met criteria go without testing. Based on review of this data set, the two most common reasons for not completing testing was failure to recognizing that the patients meet criteria and failure to complete the extra clinic visit with the genetic counselor after referral.This study shows that Hispanic patients meet criteria for genetic testing at a slightly higher rate than Non-Hispanic patients and are at risk for not completing genetic testing even in a specialized clinic. Additional patients continue to be added to this dataset, but initial potential interventions include same time genetic counselling and testing when appropriate at the initial consultation with medical oncology or the offering of universal testing to this high-risk population.
Citation Format: Allysa Lynn Garcia, Niklesh Akula, Daniel Kade Derrick, Christopher M Worrell, Simren Lakhotia, Shwetha Menon, Kate Lathrop. Optimizing genetic testing in Hispanic women with breast cancer [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 P2-09-12.