Cancer screening and breast cancer family history in Spanish-speaking Hispanic/Latina women in California

Lizeth I Tamayo; Fabian Perez; Angelica Perez; Miriam Hernandez; Alejandra Martinez; Xiaosong Huang; Valentina A Zavala; Elad Ziv; Susan L Neuhausen; Luis G Carvajal-Carmona; Ysabel Duron; Laura Fejerman

doi:10.3389/fonc.2022.940162

Cancer screening and breast cancer family history in Spanish-speaking Hispanic/Latina women in California

Front Oncol. 2022 Oct 26:12:940162. doi: 10.3389/fonc.2022.940162. eCollection 2022.

Authors

Affiliations

¹ Department of Public Health Sciences, The University of Chicago, Chicago, IL, United States.
² Department of Public Health Sciences, University of California, Davis, Davis, CA, United States.
³ Vision y Compromiso, Los Angeles, CA, United States.
⁴ Promoters for Better Health, Pomona, CA, United States.
⁵ Department of General Internal Medicine, University of California, San Francisco, San Francisco, CA, United States.
⁶ Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, United States.
⁷ Department of Biochemistry and Molecular Medicine, University of California, Davis, Davis, CA, United States.
⁸ Comprehensive Cancer Center, University of California Davis, Sacramento, CA, United States.
⁹ The Latino Cancer Institute, San Jose, CA, United States.

Abstract

Background: Breast cancer is the most common cancer among women in the U.S. and the leading cause of cancer death among Hispanics/Latinas (H/L). H/L are less likely than Non-H/L White (NHW) women to be diagnosed in the early stages of this disease. Approximately 5-10% of breast cancer can be attributed to inherited genetic mutations in high penetrance genes such as BRCA1/2. Women with pathogenic variants in these genes have a 40-80% lifetime risk of breast cancer. Past studies have shown that genetic counseling can help women and their families make informed decisions about genetic testing and early cancer detection or risk-reduction strategies. However, H/L are 3.9-4.8 times less likely to undergo genetic testing than NHW women. We developed a program to outreach and educate the H/L community about hereditary breast cancer, targeting monolingual Spanish-speaking individuals in California. Through this program, we have assessed cancer screening behavior and identified women who might benefit from genetic counseling in a population that is usually excluded from cancer research and care.

Materials and methods: The "Tu Historia Cuenta" program is a promotores-based virtual outreach and education program including the cities of San Francisco, Sacramento, and Los Angeles. Participants responded to three surveys: a demographic survey, a breast cancer family history survey, and a feedback survey. Survey responses were described for participants and compared by area where the program took place using chi-square, Fisher exact tests, and t tests. Multinomial logistic regression models were used for multivariate analyses.

Results and conclusion: We enrolled 1042 women, 892 completed the cancer family history survey and 62 (7%) provided responses compatible with referral to genetic counseling. We identified 272 women (42.8% ages 40 to 74 years) who were due for mammograms, 250 women (24.7% ages 25 to 65 years) due for Papanicolaou test, and 189 women (71.6% ages 50+) due for colorectal cancer screening. These results highlight the need of additional support for programs that spread awareness about cancer risk and facilitate access to resources, specifically within the H/L community.

Keywords: Hispanic/Latina; breast cancer health disparities; cancer education; cancer family history; hereditary breast cancer.