The American Cancer Society has awarded Jeffrey Weitzel, M.D., chief of the Division of Clinical Cancer Genetics, a five-year, $1.9 million grant to assess whether culturally sensitive outreach and education can improve Latinas’ participation in genetic counseling for cancer risk.
While lung cancer kills more U.S. women than any other cancer, breast cancer is the leading cause of cancer death for Latinas in this country.
|Jeffrey Weitzel (Photo by Alicia Di Rado)|
Many Latinas carry a BRCA gene mutation that places them at higher risk of developing breast and ovarian cancer, Weitzel said. However, many are unaware of the mutation or have no access to care, including genetic cancer risk counseling.
Mutations in genes called BRCA1 and BRCA2 can greatly increase a woman’s risk of developing breast and ovarian cancers; genetic risk assessment can uncover whether a woman has these mutations. Weitzel’s genetic epidemiologic research has shown that certain BRCA mutations 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.
Through genetic counseling, women learn about their heredity and personal cancer risk factors and get help from professionals on how to manage that risk.
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 noted that many women referred to the program passed up the potentially lifesaving consultation.
“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,” said Weitzel, who also directs City of Hope’s Cancer Screening & Prevention Program.
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. Weitzel’s group aimed to remove the fear factor. They tested whether a technique called adapted motivational interviewing delivered in advance by telephone could improve attendance at screenings.
“We found that 88 percent of patients who received the phone call attended their screening appointment,” Weitzel said, marking a significant improvement. Based on the findings, he 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 study will be conducted in collaboration with Los Angeles County + USC Medical Center and Olive View-UCLA Medical Center and aims to enroll 344 Latinas scheduled for genetic cancer risk assessment.
Weitzel noted that improved use of genetic counseling among Latinas has great potential directly to reduce breast cancer incidence and deaths in an underserved population. The assessments use women’s family history, genetics and environmental and lifestyle factors to point out personal cancer risk, and with this information, professionals can help women “outsmart cancer” and take steps to deter the disease, such as preventive surgery, medications or more frequent screenings.
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.