Nevertheless, Pal’s research raises important questions for further study, especially identifying the factors that influence why some groups of women are more likely to pursue genetic testing and then follow up with prophylactic risk management. Pal acknowledged that while several practice-changing events have occurred since her study, questions remain, for example, about the impact of the Affordable Care Act, as well as the substantially lower costs of testing when patent restrictions on the BRCA
test were lifted. “We used to pay more than $4000 for BRCA
testing; we can now get that as low as $200-$250, with multiple genes included,” she said.
In addition, Pal asked, “While the Angelina Jolie disclosure increased awareness, has that equally increased awareness across all populations? I’m not sure about that. I don’t think anyone is.”
“We really need to understand the reasons why women are making these decisions,” Pal concluded. “Are they being given the opportunity to make an informed decision, or are other factors coming into play so that they are not getting the information they need? Our study highlights the need for interventions to ensure access to testing, as well as cancer risk management practices, across all populations.”
Pal T, Cragun D, Lewis C, et al. Disparities in cancer risk management among BRCA carriers across a diverse sample of young black, Hispanic, and non-Hispanic white breast cancer survivors. J Clin Oncol. 2016;34(suppl; abstr LBA1504).
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