Early Detection for Women’s Cancer: Disparities and Prevention in Vulnerable Women

Principal Investigator: Daniela M. Dinulescu, Ph.D.

Authors: Jessica Tall and Daniela M. Dinulescu, Ph.D.
Lay Abstract

Ovarian cancer is the most lethal gynecological cancer with current screening methods having little impact in reducing mortality. Only current viable option for high-risk BRCA mutation carriers is to undergo genetic screening and risk reduction surgery by age 35-40 years or after childbearing is complete. Minority, immigrant, lower socioeconomic/educated women have lower rates of BRCA screening and early detection tests.

Psychological distress is a major barrier for minority women undergoing early screening due to fear and embarrassment associated with the procedure, severe cancer specific distress, and racial discrimination, especially for Black women. Language barriers may lower mammography screening rates and are less likely to receive genetic counseling and referrals for immigrant women. Having trained interpreters in the examination room may increase patient- provider communication, bridging language gaps. Lower education/socioeconomic status reduces early screening including a lack of access to education about modifiable cancer risk behaviors and available preventive health care resources.

Vulnerable women who carry BRCA mutations are at a higher risk of diagnosis with ovarian cancer, resulting in higher mortality rates. We need to increase diversity in medicine and to facilitate access to professional-trained translators and implement education programs to address disparities and promote advocacy.

Scientific Abstract

Ovarian cancer is the most lethal gynecological cancer with current screening methods having little impact in reducing mortality. Only current viable option for high-risk BRCA mutation carriers is to undergo genetic screening and risk reduction surgery by age 35-40 years or after childbearing is complete. Minority, immigrant, lower socioeconomic/educated women have lower rates of BRCA screening and early detection tests.

Psychological distress is a major barrier for minority women undergoing early screening due to fear and embarrassment associated with the procedure, severe cancer specific distress, and racial discrimination, especially for Black women. Language barriers may lower mammography screening rates and are less likely to receive genetic counseling and referrals for immigrant women. Having trained interpreters in the examination room may increase patient-provider communication, bridging language gaps. Lower education/socioeconomic status reduces early screening including a lack of access to education about modifiable cancer risk behaviors and available preventive health care resources.

Vulnerable women who carry BRCA mutations are at a higher risk of diagnosis with ovarian cancer, resulting in higher mortality rates. We need to increase diversity in medicine and to facilitate access to professional-trained translators and implement education programs to address disparities and promote advocacy.

Clinical Implications
Having trained interpreters, affordable educational programs, and improved patient advocacy training can improve health outcomes for vulnerable women. Having these initiatives expand into rural and impoverished areas can increase health equity and tackle systemic health issues that plaque women.

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