Clinical Breast Cancer, Volume 21, June 2021,
Background: Genomic medicine has led to significant advancements in the prevention and treatment of cancer. The National Comprehensive Cancer Network (NCCN) guidelines recommend BRCA1/2 screening in high-risk individuals; however, the guidelines have not incorporated differences within ethnic cohorts beyond Ashkenazi Jewish ethnicity. We analyzed the prevalence of BRCA1/2 mutations in various ethnicities and identified high-risk personal characteristics and family history incorporating differences within ethnic cohorts beyond Ashkenazi Jewish ethnicity. Patients and Methods: We reviewed data collected by a Michigan medical genetic clinic in a community-based hospital from 2008 to 2018. A retrospective chart analysis was conducted of 1090 patients who received genetic counseling regarding hereditary cancer syndromes. Results: We found a statistically significant higher rate of pathogenic BRCA1/2 mutation prevalence in African American patients, at 8.1%, compared to non-Ashkenazi Jewish white patients, at 3.6% (P =.02). African Americans have a mutational prevalence nearing that of the Ashkenazi Jewish population. Conclusion: Revision of the NCCN guidelines regarding hereditary cancer syndrome testing in various ethnic groups is imperative and overdue. Future studies are needed to identify health care disparities in and socioeconomic barriers to genetic testing.
Adult; African American; African Americans; Article; BRCA; BRCA1 Protein; BRCA2 Protein; Breast Cancer; Breast Neoplasms; Breast Tumor; Cancer Screening; Cancer Survival; Cohort Analysis; Community Hospital; Controlled Study; Early Cancer Diagnosis; Early Detection Of Cancer; Epidermal Growth Factor Receptor 2; Estrogen Receptor; Ethnic Difference; Ethnic Group; Ethnology; Family History; Female; Gene Mutation; Genes, BRCA1; Genes, BRCA2; Genetic Analysis; Genetic Counseling; Genetic Screening; Genetic Susceptibility; Genetic Testing; Genetics; Health Care Disparities; Health Care Disparity; Healthcare Disparities; Hereditary Breast Cancer Syndromes; Hereditary Tumor Syndrome; High Risk Population; Human; Humans; Major Clinical Study; Male; Melanoma; Middle Aged; Mutation Rate; Ovary Cancer; Pancreas Cancer; Population; Practice Guideline; Prevalence; Progesterone Receptor; Prostate Cancer; Retrospective Studies; Retrospective Study; Risk Factor; Risk Factors; Tumor Suppressor Gene; United States; Global