The influence of acculturation and breast cancer‐specific distress on perceived barriers to genetic testing for breast cancer among women of African descent

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Abstract
Objective: Rising health disparities are increasingly evident in relation to use of genetic services (including genetic counseling and testing) for breast cancer risk, with women of African descent less likely to use genetic services compared with Whites. Meanwhile, little is known regarding potential within‐group acculturation and psychological differences underlying perceived barriers to genetic testing among women of African descent. Methods: Hypothesized contributions of acculturation factors and breast cancer‐specific distress to perceived barriers to genetic testing were examined with a statistical analysis of baseline data from 146 women of African descent (56% US born and 44% foreign born) meeting genetic breast cancer risk criteria and participating in a larger longitudinal study that included the opportunity for free genetic counseling and testing. Perceived barriers assessed included: (1) anticipation of negative emotional reactions, (2) stigma, (3) confidentiality concerns, (4) family‐related worry, and (5) family‐related guilt associated with genetic testing. Results: In multivariate analyses, being foreign born was a significant predictor of anticipated negative emotional reactions about genetic testing (β=0.26; SE=0.11; p=0.01). Breast cancer‐specific distress scores (avoidance symptoms) were positively related to anticipated negative emotional reactions (β=0.02; SE=0.005; p=p=0.02), and family‐related guilt (β=0.02; SE=0.01; p=0.0009) associated with genetic testing. Conclusions: Results suggest an influence of acculturation and breast cancer‐specific distress on perceived barriers to genetic testing among women of African descent. The potential utility of culturally tailored genetic counseling services taking into account such influences and addressing emotional and psychological concerns of women considering genetic testing for breast cancer should be investigated. Copyright © 2008 John Wiley & Sons, Ltd.