Vadaparampil, Susan T.

Objective The objective was to examine age- and sex-specific cancer prevention and screening practices among 1820 Asian Indian (AI) adults in the United States using items from the 2000 National Health Interview Survey Cancer Control Topical Module. Methods A cross-sectional study of 1820 randomly selected AIs living in 7 US cities. Data were collected via telephone interviews by trained multilingual AI staff; the response rate was 62%. The primary outcome variables were age- and sex-specific cancer screening behaviors. Results Most of the AIs are men, married, educated, and with some form of health insurance. One fifth reported a family history of cancer. Adherence to mammography, Papanicolaou test, and clinical breast examination was higher in contrast to low rates of breast self-examination in women. Similarly, men reported low clinical testicular examination and fecal occult blood test, although prostate-specific antigen screening was higher than the reported rates among Asian Americans. Men were more likely to get a colonoscopy than women. The length of time in the United States had a relatively weak effect, and a family history of cancer had a moderate effect on screening behavior. Education and access to health care increased the odds (2-6 times) of cancer screening in AI men and women. Conclusions Cancer screening varies by educational level, years lived in the United States, and access to health care, among AIs living in the United States. Differences in sociodemographic factors should be considered to predict adherence to cancer screening guidelines and also be factored into patient education in this ethnic subgroup.

Studies indicate variant of uncertain significance (VUS) results are challenging for genetic counselors and patients, often resulting in negative patient outcomes. Genetic counselors' current practices regarding VUS are unknown. This study utilized a national survey of genetic counselors (n = 932) to examine current practices and confidence related to disclosing BRCA VUS results and reclassification information. For participants (n = 398), descriptive statistics were calculated regarding patient demographic characteristics, practices and confidence, and cross tabulation was used to identify participant's actions when receiving a reclassified VUS. Upon receiving a BRCA VUS report, the majority reported providing patients with information about the frequency with which their VUS was seen and patient ancestry, but a minority discussed DNA banking. Most were confident in their understanding of, and ability to explain, VUS results to patients, but felt less confident about achieving high levels of patient understanding. Upon reclassification, the majority reported calling the patient and mailing the results, but when the reclassification was deleterious, the majority also met with the patient face‐to‐face. Given the lack of standard professional guidelines about informing patients of initial and reclassified VUS results, this overview provides important insight into genetic counselors' current practices and confidence.

Abstract Aim: To examine medical and lifestyle preventive behaviors among women with varying levels of familial breast cancer risk. Methods: Using cross-sectional data from the Minnesota Breast Cancer Family Study, a historical cohort of 426 families, we compared medical (mammography adherence, antiestrogen use, and prophylactic surgery) and lifestyle (physical activity, smoking, alcohol, and diet) behaviors across three groups of cancer-free women ages 18 to 95 defined by their family history of breast cancer. Family history was classified as high-risk, moderate-risk, or average to low-risk depending on the number and degree of relationship of family members with breast cancer. Results: After adjusting for age and education, high-risk women were twice as likely to have ever used an antiestrogenic agent (9.0% versus 4.6% among moderate-risk and 4.1% among average to low-risk; P = 0.002). Among women ages <40, the high-risk group were more likely to have ever had a mammogram (82% versus 47% among moderate-risk and 35% among average to low-risk; P < 0.001). Average to low-risk women were the least likely to be current smokers and high-risk women may consume slightly fewer fruits and vegetables compared with the other groups, but there were no other differences in lifestyle behaviors, including physical activity and alcohol use. Conclusions: Women with strong family histories of breast cancer are more likely to undertake medical but not lifestyle preventive behaviors.