Project 462218

Cancer screening of high-risk populations for predisposition genes (e.g., breast cancer and BRCA1/2) is critical for early detection, cancer prevention and genetic testing for at-risk relatives. Yet, there are racial and ethnic disparities at every stage of the genetics service pathway: Racial and ethnic disparities occur at each stage in the cancer genetics service pathway: racialized and ethnic individuals are less likely to be referred for genetic tests, and are more likely to receive inconclusive genetic test results. Both can be barriers to appropriate screening for, and prevention of, cancer. We will use multiple methods to 1) explore experiences, needs, barriers and enablers to accessing cancer genetics services among racialized and ethnic patients and among health care providers, and 2) characterize the nature and extent of racial and ethnic disparities in cancer genetics services, genetic diagnoses, and recommendations for risk-reducing management. First, we will use qualitative methods to explore racialized patients' and providers' experiences, needs, barriers and enablers to accessing cancer genetics services. We will then use quantitative methods to characterize the nature and extent of racial disparities in cancer genetics services, genetic diagnoses, and recommendations for risk-reducing management. Evidence on which populations are experiencing disparities, and at which junctures in the care pathway disparities occur is a critical first step to address these disparities. This project will lay the groundwork for subsequent work to co-design and evaluate interventions to optimize access and delivery of cancer genetics services.