The American College of Obstetricians and Gynecologists (ACOG) has emphasized preventive genetic testing for patients who have a familial history of breast and ovarian cancer as a routine standard of ob-gyn care. In the past decade, there has been an increased demand and utilization for genetic testing and in many practices it is now commercially available. The benefits of predictive and preventative genetic testing are well established, however their use will be determined by patient’s motivation to undergo testing as well as their access to testing. As the momentum of genetic testing is growing, healthcare providers must mobilize the movement so that it does not become yet another population prejudice affecting health care outcomes. Additionally, the provider offering genetic testing should have a sound understanding of cancer genetics and implications for testing. This article will review the current disparities in genetic testing, specifically BRCA testing for black women in the United States, and identify ways in which medical providers can counsel their patients around the decision to partake in preventive genetic testing.
The Disparity of Breast Cancer in the United States The United States (US) experiences one of the largest public health inequalities in its breast and ovarian cancer mortality rates. Mortality in the US for breast cancer in white women is 28 deaths per 100,000 compared with 36 deaths per 100,000 in black women (Danforth, 2013). This disparity is
The Human Genome Project is the largest scientific endeavor undertaken since the Manhattan Project, and, as with the Manhattan Project, the completion of the Human Genome Project has brought to surface many moral and ethical issues concerning the use of the knowledge gained from the project. Although genetic tests for certain diseases have been available for 15 years (Ridley, 1999), the completion of the Human Genome Project will certainly lead to an exponential increase in the number of genetic tests available. Therefore, before genetic testing becomes a routine part of a visit to a doctor's office, the two main questions at the heart of the controversy surrounding genetic testing must be
Many people have a negative outlook on prenatal genetic testing but that is because they are not educated on the goals
This will explore the role gender, ethnicity, race and socio-economics play in the acquisition, maintenance and experience of health care. A particular focus is the interaction (intersection) between these elements and their effect on awareness, education, active prevention and early detection of cancer, particularly breast cancer in women. Cancer is a disease caused by a mutation and rapid division of cells. Cancer is a general term describing many diseases; essentially there is a wide array of types of cancers. This vast differentiation makes it difficult to combat this disease and similarly the differences among individuals cause the course of this disease to vary greatly, cancer effects people differently. Breast cancer is one of the more well-known forms of cancer and is frequently touched upon or glazed over in discussion. A conversation may start with “I know someone who has or had cancer” but way to often this is where the conversation ends. The discussion on breast cancer needs to expand, to further the spread of information and understanding of the many aspects of this disease. “Breast cancer is a malignant tumor that starts in the cells of the breast. A malignant tumor is a group of cancer cells that can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body” (What is Breast cancer). Breast cancer can be found in both male and female populations but it is particularly, prevalent among women, Breast cancer is the most pervasive
According to genetics and social science research there are striking differences between White and minority populations affected with breast cancer in the U.S. These disparities are likely due to a combination of cultural, environmental and genetic factors that differ between the groups. Historically, scientists have separately explored either the genetic or the social/behavioral contributions to cancer. The research team profiled in this case study takes the position that we cannot effectively grasp the complexity of cancer etiology, nor design appropriate
“African Americans have the highest death rate form all cancer sites combined and from malignancies of the lung and bronchus, colon and rectum, female breast, prostate, and cervix of all racial or ethnic groups in the United States (Elizabeth ward, 2004). The health disparities in African Americans and other racial groups are alarming. For this essay I choose to focus on the empirical facts on the disparities between African American women and European American women who are diagnosed with breast cancer and the disparity in mortality rates. Therefore many of the studies I found linked the disparity to race, poverty and environmental factors. American cancer society estimates, that in 2017 there will be 252,710 new breast cancer diagnosis
According to research, it has established that breast cancer is one of the leading cause of cancer death among Hispanic women despite them having a low incidence rate of breast cancer. It has attributed to the fact that most Hispanic women presents with advanced breast cancer at diagnosis, and thus is more likely to die from breast cancer compared with non-Hispanic white women. According to Banegas and Li (2012), an estimated number of 39510 breast cancer deaths in women occurred, and 226,870 new breast cancer cases were diagnosed in the US. Among all these cases, Hispanic women
Beyond discussion of this lethal disease come the individuals affected by it. In the United States alone breast cancer is the most common cancer. It is diagnosed in one out of eight women living in the United States (Stephan, 2010). Victims of breast cancer usually are more widespread amongst minorities in the U.S. African-American women and Hispanic women are most likely to have advanced diseases
Disparities of all kinds exist in modern day health care. One such disparity that is of particular interest is one that exists between Caucasian and African American women relating to their respective rates of breast cancer incidence and breast cancer survival. According to the American Cancer Society, Caucasian women have a higher incidence of breast cancer than African American women however; Caucasian women have a higher survival rate than African American women (ACS, 2006, as cited in Leshner, 2006). This is to say that although Caucasian woman have a higher rate of breast cancer compared to African American women, Caucasian women have a higher rate of survival. This finding is indeed a disparity in heath care, and one that begs the question as to why this is so. The reasons as to why this disparity exists are numerous and very complex. Several factors play a role in substantiating the disparity in mortality rates related to breast cancer in African American women, including differences in spirituality and religion, differences in education surrounding breast cancer, and differences in socio economic standing as it relates to ones health promotion
Breast cancer is the most diagnosed cancer among women. Despite the many technological advances that have been made to detect breast cancer at earlier stages, it continues to kill more women than any other cancer. Breast cancer affects all women, but the mortality rates from it are significantly higher in Black women than any other group (Hunt, Whitman, & Hurlbert, 2013). These rates are especially concerning when considering that White women are diagnosed at much higher rates.
In chapter four of her book Genetic Dilemmas, Dena Davis asserts that it is unethical for parents to subject their children to genetic testing for the markers of adult-onset genetic diseases because it places an unfair constraint on a child’s right to an open future. It both removes the child’s ability to choose whether to be tested as an adult and has the potential to negatively alter the overall trajectory of their lives. While the current consensus amongst medical professionals is that such testing should be prohibited (Davis, _____), many concerned parents correctly point out that discouraging such testing creates a conflict of interests between the “beneficence model of patient care and the rights of parents to their own autonomy”
Although African Americans have the same rate of incidence of cancer as Whites, African Americans commonly believe that they are less likely to have cancer. (Black Americans' Attitudes Toward Cancer and Cancer tests: Highlights of a study 212) This stems from the idea that cancer is a white person disease while diabetes and sickle anemia are black person diseases. “Beliefs about cancer may influence the perception of risk of developing the disease, and participation in screening programs” One’s beliefs are often developed from one’s culture. This cultural belief in addition to others, causes African Americans to be less likely to screen for cancer. As seen in a study about screening Colorectal Cancer, African American participants were less likely to screen for Colorectal Cancer due to the belief in cancer fatalism, which is to say that one will certainly die from cancer (Shavers, Brown 334). Lack of health literacy also contributed to disinterested in cancer screening, this lack of knowledge may stem from low SES that affects many African Americans or once again the disinterest in cancer as a disease that majorly affects black people. It is important to understand that African American culture to understand and therefore make screening more available to black people without fundamentally changing African American
The Goal of the Human Genome Project is to obtain genetic mapping information and to determine the complete sequence of all human DNA by the year of 2005. The project started in 1990 and 180 million dollars are being spent on it annually. This adds up to a total of over 2 billion dollars for the 15 year budget. Of this 2 billion dollars budgeted, 5% is spent annually on the ethical, legal and social issues. This report focused on some of these issues.
Genetic engineering has become increasingly normalized in today’s society, and people are exposed to this technology now more than ever before. Most people are aware that food companies practice genetic engineering on their plants in order to design the most profitable crops, but it isn’t generally known that this same technology can be applied to humans. The concept of picking certain traits and characteristics of a human may appear desirable, but many risks and potential side effects may follow considering that it is unknown what genetic engineering could affect in future generations. Francis Fukuyama, an accomplished and distinguished professor of political economy and philosopher, conveys his concern that genetic engineering is developing at a surprisingly rapid rate. Within his book, Our Posthuman Future: Consequences of the Biotechnology Revolution, he claims that genetic engineering not only will potentially be detrimental for the human race, but due to the change in nature of human beings, such engineering will also result in significantly impacting government and politics. Although genetic engineering can be seen as a huge technological advancement that could potentially help millions, there are drastic negative effects and reasons for disapproving genetic engineering that are too important to be overlooked.
Breast cancer accounts for one third of all new cancer diagnoses in the United States (Cauley, et al., 2007). The first sign in the process of this disease is a lump that forms around the breasts. For this reason, it is necessary to get the yearly mammograms once a woman reaches a certain age. Also, monthly self-examinations can aid in finding breast cancer early. If this condition is found early enough, chances of survival are abundant. Most women who get breast cancer are older than 50 with 86% of the deaths occurring in this age group (Cauley, et al., 2007). Postmenopausal women have a higher risk for breast cancer, because the risk increases when levels of endogenous estradiol rise (Cauley, et al., 2007). Breast cancer is the most common cancer that occurs in women. This epidemic has a higher incidence rate among white women than in African American women, but African American women have a higher mortality rate (Breast Cancer Risk Factors, 2010). White women are more apt to develop this disease than any other ethnicity. However, in women under 45, breast cancer is more common in African American women (Breast Cancer Risk Factors, 2010).
Why live a life with average abilities when we can enhance our abilities through genetic engineering on our DNA for the greater good? Genetic engineering is “the artificial manipulation, modification, and recombination of DNA or other nucleic acid molecules in order to modify an organism or population of organisms.” It is not exactly a science in a broad sense, but a branch of biotechnology, which uses methods of molecular and biology, virology, and genetics. Genetic engineering on the human genome should be approved because it has the potential to make lives and the world better. Genetic disorders could be permanently eliminated, certain genes could be reactivated for regrowth of necessary cells, eliminating many neurological disorders, and delaying ageing, which would expand scientific research in order to many world complications.