Gender Disparity in Cancer Genetic Testing Influenced by Men With HBOC Risk

Women are 3 times more likely to receive cancer genetic testing than men, according to a research letter published in JAMA Oncology.

Genetic testing represents an important role in oncology, providing a roadmap for prevention efforts and early cancer detection. “Up to 10% of cancers are attributable to inherited gene mutations, such as BRCA1/2 and those associated with Lynch syndrome,” wrote the authors of the letter. “Identifying mutation carriers is critical for treatment decisions, cancer prevention, and early detection.”

With existing evidence pointing to genetic testing disparities by education level, insurance status, and race/ethnicity, researchers assessed whether a gender gap also exists.

The 2015 US National Health Interview Survey, a cross-sectional in-person interview collecting self-reported health data, asked participants 4 subsequent questions, which were not mutually exclusive: if their test was for breast cancer, ovarian cancer, colon or rectal cancer, or other cancer. The sociodemographic factors of those receiving genetic testing were compared with the national sample.

A total of 378 adults reported a history of genetic testing for cancer. Looking at sociodemographic differences in the subsample, researchers observed that 71% of those who received testing had private insurance, compared to 2% who were uninsured. The majority (71%) were white, 10% were Hispanic, and 12% were black.

While 73% of women reported receiving genetic testing, just 27% of men reported the same. The gender disparity persisted among those who reported they had a history of cancer as well as those who reported they did not. Of those affected by cancer that received testing, 81% were women, and unaffected men (33%) tested at half the rate of unaffected women (67%).

Three-quarters of genetic testing (76%) was for breast/ovarian cancer, 24% was for colorectal cancer, and 22% was for other cancers. Of those testing for breast/ovarian cancer, 92% were women, largely attributing to the overall disparity between genders. Among colorectal cancers and other cancers, there were no significant differences in testing by gender.

Noting the 10 to 1 disparity in breast/ovarian cancer testing, the authors of the study highlighted theories for underutilization among men, including the lack of patient and clinician awareness on the importance of hereditary breast and ovarian cancer (HBOC) mutation status—despite the risks of male breast, pancreatic, melanoma, and aggressive prostate cancers.

“Large national efforts, including educational campaigns targeting HBOC testing, must address this disparity to enable uniform opportunities for cancer prevention, early detection, and treatment for all at-risk individuals and their family members,” they concluded.

Reference

Childers K, Maggard-Gibbons M, Macinko J, et al. National distribution of cancer genetic testing in the United States [published online April 26, 2018]. JAMA Oncol. doi:10.1001/jamaoncol.2018.0340.