Research Article| Volume 169, P125-130, February 2023

Download started.


Genetic Testing in the Latinx community: Impact of acculturation and provider relationships

Published:December 26, 2022DOI:


      • Latinx women with higher acculturation are more likely to consider genetic testing.
      • Latinx women more likely to consider testing if recommended by trusted provider.
      • Education levels positively correlated with intention to undergo genetic testing.



      The current study aimed to explore attitudes toward genetic germline testing and intentions to test in Latinas from Southern California. We hypothesized that patients' acculturation and education levels, as well as comfort with health care providers, are positively associated with attitudes and intentions toward genetic testing.


      A survey was offered concurrently to Latinx female patients at a gynecologic oncology practice and to unaffiliated Latinx community members. The survey assessed demographics, structural, psychosocial, and acculturation factors and genetic testing attitudes and intentions via validated scales.


      Of 148 surveys collected, 66% of responders had low levels of acculturation. 50% of women had government-subsidized insurance; 22% had no schooling in the US. 67% of participants did not carry a diagnosis of cancer.
      Women with higher acculturation levels were more likely to consider genetic testing (rs = 0.54, p = .001). Higher acculturated women and less acculturated women under 50 were more likely to consider testing if it had been recommended by a female, trusted, or Hispanic/Latinx provider (rs = 0.22, p = .01, rs = 0.27, p = .003 and rs = 0.19, p = .003, respectively) or if there was a recent cancer diagnosis (self or family, rs = 0.19, p = .03). Overall, education correlated with intention to test. The more education outside of the US, the less negative was the attitude toward being tested (rs = −0.41, p = .002).


      Direct experiences with cancer, more schooling and higher acculturation coupled with provider characteristics determined if Latinas were more open to testing. Provider characteristics mattered: having a female, Latinx, Spanish speaking provider was important for genetic testing decision-making. These findings are particularly pertinent in areas with high Latinx populations.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Gynecologic Oncology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Siegel R.L.
        • Miller K.D.
        • Fuchs H.E.
        • Jemal A.
        Cancer statistics, 2021.
        CA Cancer J. Clin. 2021; 71: 7-33
        • Norquist B.M.
        • et al.
        Inherited mutations in women with ovarian carcinoma.
        JAMA Oncol. 2016; 2: 482-490
        • Walsh T.
        • et al.
        Mutations in 12 genes for inherited ovarian, fallopian tube, and peritoneal carcinoma identified by massively parallel sequencing.
        Proc. Natl. Acad. Sci. U. S. A. 2011; 108: 18032-18037
        • Alsop K.
        • et al.
        BRCA mutation frequency and patterns of treatment response in BRCA mutation-positive women with ovarian cancer: a report from the Australian Ovarian Cancer Study Group.
        Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2012; 30: 2654-2663
        • Pietragalla A.
        • Arcieri M.
        • Marchetti C.
        • Scambia G.
        • Fagotti A.
        Ovarian cancer predisposition beyond BRCA1 and BRCA2 genes.
        International Journal of Gynecological Cancer. 2020; 30: 1803-1810
        • Miki Y.
        • et al.
        A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1.
        Science. 1994; 266: 66-71
        • Daly M.B.
        • et al.
        Genetic/familial high-risk assessment: breast, ovarian, and pancreatic, version 2.2021, NCCN clinical practice guidelines in oncology.
        J. Natl. Compr. Cancer Netw. 2021; 19: 77-102
        • Mallen A.R.
        • et al.
        Patterns and predictors of genetic referral among ovarian cancer patients at a National Cancer Institute-Comprehensive Cancer Center.
        Clin. Genet. 2020; 97: 370-375
        • Armel S.R.
        • et al.
        Setting a baseline: a 7-year review of referral rates and outcomes for serous ovarian cancer prior to implementation of oncologist mediated genetic testing.
        Gynecol. Oncol. 2020; 158: 440-445
        • Meiser B.
        • et al.
        Evaluation of implementation of risk management guidelines for carriers of pathogenic variants in mismatch repair genes: a nationwide audit of familial cancer clinics.
        Familial Cancer. 2020; 19: 337-346
        • Levy D.E.
        • et al.
        Underutilization of BRCA1/2 testing to guide breast cancer treatment: black and Hispanic women particularly at risk.
        Genet Med. 2011; 13: 349-355
        • Hann K.E.J.
        • et al.
        Awareness, knowledge, perceptions, and attitudes towards genetic testing for cancer risk among ethnic minority groups: a systematic review.
        BMC Public Health. 2017; 17: 503
        • John E.M.
        • et al.
        Prevalence of pathogenic BRCA1 mutation carriers in 5 US racial/ethnic groups.
        JAMA. 2007; 298: 2869-2876
        • Villarreal-Garza C.
        • et al.
        Significant clinical impact of recurrent BRCA1 and BRCA2 mutations in Mexico.
        Cancer. 2015; 121: 372-378
        • Weitzel J.N.
        • et al.
        Prevalence and type of BRCA mutations in Hispanics undergoing genetic cancer risk assessment in the southwestern United States: a report from the clinical cancer genetics community research network.
        Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2013; 31: 210-216
        • Weitzel J.N.
        • et al.
        Prevalence of BRCA mutations and founder effect in high-risk Hispanic families.
        Cancer Epidemiol. Biomark. Prev. 2005; 14: 1666-1671
        • Kurian A.W.
        • et al.
        Genetic testing and results in a population-based cohort of breast cancer patients and ovarian cancer patients.
        Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2019; 37: 1305-1315
        • McGuinness J.E.
        • et al.
        Uptake of genetic testing for germline BRCA1/2 pathogenic variants in a predominantly Hispanic population.
        Cancer Genet. 2019; 235-236: 72-76
        • Mai P.L.
        • et al.
        Awareness of cancer susceptibility genetic testing: the 2000, 2005, and 2010 National Health Interview Surveys.
        Am. J. Prev. Med. 2014; 46: 440-448
        • Gammon A.D.
        • et al.
        Awareness and preferences regarding BRCA1/2 genetic counseling and testing among Latinas and non-Latina white women at increased risk for hereditary breast and ovarian cancer.
        J. Genet. Couns. 2011; 20: 625-638
        • Cragun D.
        • Weidner A.
        • Kechik J.
        • Pal T.
        Genetic testing across young Hispanic and non-Hispanic white breast cancer survivors: facilitators, barriers, and awareness of the genetic information nondiscrimination act.
        Genet Test Mol Biomarkers. 2019; 23: 75-83
        • Heck J.E.
        • Franco R.
        • Jurkowski J.M.
        • Sheinfeld Gorin S.
        Awareness of genetic testing for cancer among United States Hispanics: the role of acculturation.
        Community Genet. 2008; 11: 36-42
        • Hurtado-de-Mendoza A.
        • Jackson M.C.
        • Anderson L.
        • Sheppard V.B.
        The role of knowledge on genetic counseling and testing in black cancer survivors at increased risk of carrying a BRCA1/2 mutation.
        J. Genet. Couns. 2017; 26: 113-121
        • Meisel S.F.
        • et al.
        Genetic testing and personalized ovarian cancer screening: a survey of public attitudes.
        BMC Womens Health. 2016; 16: 46
        • Petzel S.V.
        • et al.
        Genetic risk assessment for women with epithelial ovarian cancer: referral patterns and outcomes in a university gynecologic oncology clinic.
        J. Genet. Couns. 2013; 22: 662-673
        • Davidson B.A.
        • et al.
        Preferences of women with epithelial ovarian cancer for aspects of genetic testing.
        Gynecol Oncol Res Pract. 2019; 6: 1
        • Henneman L.
        • et al.
        Public attitudes towards genetic testing revisited: comparing opinions between 2002 and 2010.
        Eur. J. Hum. Genet. 2013; 21: 793-799
        • Hong L.
        • Gonzalez R.
        • Unternaehrer J.
        • Ioffe Y.
        Germline BRCA mutation rates in Latina women presenting for gynecologic oncology care.
        Gynecol. Obstet. Investig. 2020; 85: 214-221
        • Census, U. S
        United States Census.
        Date: 2021
        • Census
        San Bernardino, CA Census Place.
        • Kroenke K.
        • Spitzer R.L.
        • Williams J.B.
        The PHQ-9: validity of a brief depression severity measure.
        J. Gen. Intern. Med. 2001; 16: 606-613
        • Spitzer R.L.
        • Kroenke K.
        • Williams J.B.
        • Lowe B.
        A brief measure for assessing generalized anxiety disorder: the GAD-7.
        Arch. Intern. Med. 2006; 166: 1092-1097
        • Pargament K.
        • Feuille M.
        • Burdzy D.
        The brief RCOPE: current psychometric status of a short measure of religious coping.
        Religions. 2011; 2: 51-76
        • Deyo R.A.
        • Diehl A.K.
        • Hazuda H.
        • Stern M.P.
        A simple language-based acculturation scale for Mexican Americans: validation and application to health care research.
        Am. J. Public Health. 1985; 75: 51-55
        • Norris A.E.
        • Ford K.
        • Bova C.A.
        Psychometrics of a brief acculturation scale for Hispanics in a probability sample of urban Hispanic adolescents and young adults.
        Hisp. J. Behav. Sci. 1996; 18: 29-38
        • Sussner K.M.
        • Jandorf L.
        • Thompson H.S.
        • Valdimarsdottir H.B.
        Interest and beliefs about BRCA genetic counseling among at-risk Latinas in New York City.
        J. Genet. Couns. 2010; 19: 255-268
        • Sussner K.M.
        • Jandorf L.
        • Thompson H.S.
        • Valdimarsdottir H.B.
        Barriers and facilitators to BRCA genetic counseling among at-risk Latinas in New York City.
        Psychooncology. 2013; 22: 1594-1604
        • Sussner K.M.
        • et al.
        BRCA genetic counseling among at-risk Latinas in New York City: new beliefs shape new generation.
        J. Genet. Couns. 2015; 24: 134-148
        • Chapman-Davis E.
        • et al.
        Racial and ethnic disparities in genetic testing at a hereditary breast and ovarian Cancer center.
        J. Gen. Intern. Med. 2021; 36: 35-42
        • Pace L.E.
        • et al.
        BRCA1/2 testing in Massachusetts among women with private insurance or Medicaid, 2011-2015.
        Med. Care. 2020; 58: 963-967
        • Chalela P.
        • Pagan J.A.
        • Su D.
        • Munoz E.
        • Ramirez A.G.
        Breast cancer genetic testing awareness, attitudes and intentions of Latinas living along the US-Mexico border: a qualitative study.
        J Community Med Health Educ. 2012; 2
        • Chasan-Taber L.
        • Kini N.
        • Harvey M.W.
        • Pekow P.
        • Dole N.
        The association between acculturation and prenatal psychosocial stress among Latinas.
        J. Immigr. Minor. Health. 2020; 22: 534-544
        • Lara M.
        • Gamboa C.
        • Kahramanian M.I.
        • Morales L.S.
        • Bautista D.E.
        Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context.
        Annu. Rev. Public Health. 2005; 26: 367-397
        • Barcelona de Mendoza V.
        • Harville E.
        • Theall K.
        • Buekens P.
        • Chasan-Taber L.
        Effects of acculturation on prenatal anxiety among Latina women.
        Arch Womens Ment Health. 2016; 19: 635-644
        • Barcelona de Mendoza V.
        • Harville E.
        • Theall K.
        • Buekens P.
        • Chasan-Taber L.
        Acculturation and adverse birth outcomes in a predominantly Puerto Rican population.
        Matern. Child Health J. 2016; 20: 1151-1160
        • Sussner K.M.
        • Thompson H.S.
        • Valdimarsdottir H.B.
        • Redd W.H.
        • Jandorf L.
        Acculturation and familiarity with, attitudes towards and beliefs about genetic testing for cancer risk within Latinas in East Harlem, New York City.
        J Genet Couns. 2009; 18: 60-71