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. 2023 Sep:9:e2300154.
doi: 10.1200/GO.23.00154.

Breast Cancer Germline Genetic Counseling and Testing for Populations of African Heritage Globally: A Scoping Review on Research, Practice, and Bioethical Considerations

Yoshiko Iwai  1 , Kadiata Toumbou  2 , Takondwa Zuze  3 , Jenny S Morgan  4   5   6 , Lusayo Simwinga  3 , Sarah T Wright  7 , Yuri Fedoriw  8 , Oluwadamilola T Oladeru  9   10 , Onyinye D Balogun  11 , Mya L Roberson  12 , Olufunmilayo I Olopade  13 , Tamiwe Tomoka  3 , Shekinah N C Elmore  14
Affiliations

Breast Cancer Germline Genetic Counseling and Testing for Populations of African Heritage Globally: A Scoping Review on Research, Practice, and Bioethical Considerations

Yoshiko Iwai et al. JCO Glob Oncol. 2023 Sep.

Abstract

Purpose: Despite the disproportionately high risk of breast cancer among women of African heritage, little is known about the facilitators and barriers to implementing germline genetic testing and counseling (GT/C).

Methods: This scoping review followed guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Published manuscripts from database inception through 2021 were sourced from PubMed, Cumulative Index to Nursing and Allied Health Literature via EBSCO, Embase, Cochrane Library, and Scopus. Search terms were used to retrieve articles addressing (1) African heritage, (2) breast cancer, and (3) GT or GC. The screening involved abstract and title review and full-text review. Data were extracted for all articles meeting the inclusion criteria.

Results: A total of 154 studies were included. Most studies that took place were conducted in the United States (71.4%), and most first authors (76.9%) were from the United States. GT was conducted in 73 (49.7%) studies. BRCA1/BRCA2 were the most commonly studied genes for germline mutations. GC was conducted in 49 studies (33.3%), and perspectives on GC were evaluated in 43 (29.3%). The use of racial/ethnic categories varied broadly, although African American was most common (40.1%). Racism was mentioned in three studies (2.0%).

Conclusion: There is a growing body of literature on GT/C for breast cancer in women of African heritage. Future studies on GT/C of African populations should consider increased clarity around racial/ethnic categorizations, continued community engagement, and intentional processes for informed consent.

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Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/go/authors/author-center.

Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).

Figures

FIG 1
FIG 1
Map of countries included in scoping review. Geographic representation of studies on germline genetic testing/counseling for breast cancer.
FIG 2
FIG 2
Pie chart of racial categories used by included studies.
See this image and copyright information in PMC

References

    1. Giaquinto AN, Sung H, Miller KD, et al. : Breast cancer statistics, 2022. CA Cancer J Clin 72:524-541, 2022 - PubMed
    1. Sung H, Ferlay J, Siegel RL, et al. : Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71:209-249, 2021 - PubMed
    1. Allemani C, Matsuda T, Di Carlo V, et al. : Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): Analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet 391:1023-1075, 2018 - PMC - PubMed
    1. McCormack V, McKenzie F, Foerster M, et al. : Breast cancer survival and survival gap apportionment in sub-Saharan Africa (ABC-DO): A prospective cohort study. Lancet Glob Health 8:e1203-e1212, 2020 - PMC - PubMed
    1. Joko-Fru WY, Miranda-Filho A, Soerjomataram I, et al. : Breast cancer survival in sub-Saharan Africa by age, stage at diagnosis and human development index: A population-based registry study. Int J Cancer 146:1208-1218, 2020 - PMC - PubMed

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