Changing Landscapes: Perspectives of Young African American Women of Population-Wide Testing for Hereditary Breast Cancer Mutations

Young African American women continue to die from breast cancer at higher rates than White women. In an effort to promote breast cancer prevention, population-wide testing (PWT) for all women in the U.S. starting at age 30 is a potential future initiative that is garnering a lot of attention. However, African American women currently utilize genetic testing for hereditary breast cancer at lower rates than White women. Therefore, if young African American women are not prioritized in a future roll out of PWT, then existing breast cancer and genetic testing disparities will likely continue to widen. The purpose of this dissertation was to conduct a sequential exploratory mixed methods study to understand young African American women’s (18-30 years) perspectives towards hereditary breast cancer mutations, direct to consumer testing, PWT, health communication preferences, as well as their intentions to participate in PWT. Findings from focus groups (n = 39) and a survey distributed via Qualtrics Online Sample (n =170) indicated that participants had low to moderate knowledge about hereditary breast cancer mutations and moderate to high levels of medical mistrust. Furthermore, the approval of members of their social network and the current proliferation of direct to consumer testing could influence their intentions to participate in PWT if offered in the future. As discussions continue about the potential for this new service, it will be imperative for researchers and public health practitioners to prioritize the needs and preferences of young African American women when designing interventions and potential health promotion strategies