PURPOSE Increasing use of genetic services (counseling/testing) among young breast cancer survivors (YBCS) can help decrease breast cancer incidence and mortality. The study examined use of genetic services between Black and White/Other YBCS, attitudes and knowledge of breast cancer risk factors, and reasons for disparities in using genetic services. METHODS We used baseline data from a randomized control trial including a population-based, stratified random sample of 3000 potentially eligible YBCS, with oversampling of Black YBCS. RESULTS Among 883 YBCS (353 Black, 530 White/Other) were significant disparities between the two racial groups. More White/Other YBCS had received genetic counseling and had genetic testing than Blacks. Although White/Other YBCS resided farther away from board-certified genetic counseling centers, they had fewer barriers to access these services. Black race, high out-of-pocket costs, older age, and more years since diagnosis were negatively associated with use of genetic services. Black YBCS had lower knowledge of breast cancer risk factors. Higher education and genetic counseling were associated with higher genetic knowledge. CONCLUSION Racial inequalities of cost-related access to care and education create disparities in genetic services utilization. System-based interventions that reduce socioeconomic disparities and empower YBCS with genetic knowledge, as well as physician referrals, can increase access to genetic services.

中文翻译：

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年轻乳腺癌幸存者随机样本中遗传服务利用的差异。

目的 在年轻乳腺癌幸存者 (YBCS) 中增加使用遗传服务（咨询/检测）有助于降低乳腺癌发病率和死亡率。该研究检查了黑人和白人/其他 YBCS 之间对遗传服务的使用、对乳腺癌危险因素的态度和知识，以及使用遗传服务存在差异的原因。方法 我们使用来自随机对照试验的基线数据，包括基于人群的分层随机样本，包括 3000 名可能符合条件的 YBCS，其中黑色 YBCS 过采样。结果 在 883 名 YBCS（353 名黑人，530 名白人/其他）中，两个种族群体之间存在显着差异。与黑人相比，更多的白人/其他 YBCS 接受了遗传咨询并进行了基因检测。虽然 White/Other YBCS 离董事会认证的遗传咨询中心更远，他们获得这些服务的障碍更少。黑人种族、高昂的自付费用、年龄较大以及诊断后的年数与使用遗传服务呈负相关。黑色 YBCS 对乳腺癌危险因素的了解较少。高等教育和遗传咨询与较高的遗传知识相关。结论 与成本相关的获得护理和教育的种族不平等造成了遗传服务利用的差异。以系统为基础的干预措施可以减少社会经济差距并赋予 YBCS 遗传知识，以及医生转诊，可以增加获得遗传服务的机会。黑色 YBCS 对乳腺癌危险因素的了解较少。高等教育和遗传咨询与较高的遗传知识相关。结论 与成本相关的获得护理和教育的种族不平等造成了遗传服务利用的差异。以系统为基础的干预措施可以减少社会经济差距并赋予 YBCS 遗传知识，以及医生转诊，可以增加获得遗传服务的机会。黑色 YBCS 对乳腺癌危险因素的了解较少。高等教育和遗传咨询与较高的遗传知识相关。结论 与成本相关的获得护理和教育的种族不平等造成了遗传服务利用的差异。以系统为基础的干预措施可以减少社会经济差距并赋予 YBCS 遗传知识，以及医生转诊，可以增加获得遗传服务的机会。