Skip to main content
Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 2001 Jul;38(7):425–429. doi: 10.1136/jmg.38.7.425

Cultural aspects of cancer genetics: setting a research agenda

B Meiser 1, M Eisenbruch 1, K Barlow-Stewart 1, K Tucker 1, Z Steel 1, D Goldstein 1
PMCID: PMC1757175  PMID: 11432959

Abstract

BACKGROUND—Anecdotal evidence suggests that people from non-Anglo-Celtic backgrounds are under-represented at familial cancer clinics in the UK, the USA, and Australia. This article discusses cultural beliefs as a potential key barrier to access, reviews previous empirical research on cultural aspects of cancer genetics, draws implications from findings, and sets a research agenda on the inter-relationships between culture, cancer genetics, and kinship.
METHODS—The CD-ROM databases MEDLINE, PsychLIT, CINAHL, and Sociological Abstracts were searched from 1980 onwards.
RESULTS—Cultural aspects of cancer genetics is the focus of an emerging body of publications. Almost all studies assessed African-American women with a family history of breast cancer and few studies included more diverse samples, such as Americans of Ashkenazi Jewish background or Hawaiian- and Japanese-Americans. Our analysis of published reports suggests several directions for future research. First, an increased focus on various Asian societies appears warranted. Research outside North America could explore the extent to which findings can be replicated in other multicultural settings. In addition, control group designs are likely to benefit from systematically assessing culture based beliefs and cultural identity in the "majority culture" group used for comparative purposes.
CONCLUSION—More data on which to base the provision of culturally appropriate familial cancer clinic services to ethnically diverse societies are needed. Empirical data will assist with culturally appropriate categorisation of people from other cultures into risk groups based on their family histories and provide the basis for the development of culturally appropriate patient education strategies and materials.


Keywords: hereditary cancer; kinship; culture; family history; cultural competence

Full Text

The Full Text of this article is available as a PDF (98.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Benkendorf J. L., Reutenauer J. E., Hughes C. A., Eads N., Willison J., Powers M., Lerman C. Patients' attitudes about autonomy and confidentiality in genetic testing for breast-ovarian cancer susceptibility. Am J Med Genet. 1997 Dec 19;73(3):296–303. doi: 10.1002/(sici)1096-8628(19971219)73:3<296::aid-ajmg13>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  2. Benowitz S. To tell the truth: a cancer diagnosis in other cultures is often a family affair. J Natl Cancer Inst. 1999 Nov 17;91(22):1918–1919. doi: 10.1093/jnci/91.22.1918. [DOI] [PubMed] [Google Scholar]
  3. Bowen D., Hickman K. M., Powers D. Importance of psychological variables in understanding risk perceptions and breast cancer screening of African American women. Womens Health. 1997 Fall-Winter;3(3-4):227–242. [PubMed] [Google Scholar]
  4. Burke W., Daly M., Garber J., Botkin J., Kahn M. J., Lynch P., McTiernan A., Offit K., Perlman J., Petersen G. Recommendations for follow-up care of individuals with an inherited predisposition to cancer. II. BRCA1 and BRCA2. Cancer Genetics Studies Consortium. JAMA. 1997 Mar 26;277(12):997–1003. [PubMed] [Google Scholar]
  5. Burke W., Petersen G., Lynch P., Botkin J., Daly M., Garber J., Kahn M. J., McTiernan A., Offit K., Thomson E. Recommendations for follow-up care of individuals with an inherited predisposition to cancer. I. Hereditary nonpolyposis colon cancer. Cancer Genetics Studies Consortium. JAMA. 1997 Mar 19;277(11):915–919. [PubMed] [Google Scholar]
  6. Chan T. L., Yuen S. T., Chung L. P., Ho J. W., Kwan K. Y., Chan A. S., Ho J. C., Leung S. Y., Wyllie A. H. Frequent microsatellite instability and mismatch repair gene mutations in young Chinese patients with colorectal cancer. J Natl Cancer Inst. 1999 Jul 21;91(14):1221–1226. doi: 10.1093/jnci/91.14.1221. [DOI] [PubMed] [Google Scholar]
  7. Durfy S. J., Bowen D. J., McTiernan A., Sporleder J., Burke W. Attitudes and interest in genetic testing for breast and ovarian cancer susceptibility in diverse groups of women in western Washington. Cancer Epidemiol Biomarkers Prev. 1999 Apr;8(4 Pt 2):369–375. [PubMed] [Google Scholar]
  8. Eisenbruch M., Handelman L. Cultural consultation for cancer: astrocytoma in a Cambodian adolescent. Soc Sci Med. 1990;31(12):1295–1299. doi: 10.1016/0277-9536(90)90068-4. [DOI] [PubMed] [Google Scholar]
  9. Eisinger F., Alby N., Bremond A., Dauplat J., Espié M., Janiaud P., Kuttenn F., Lebrun J. P., Lefranc J. P., Pierret J. Recommendations for medical management of hereditary breast and ovarian cancer: the French National Ad Hoc Committee. Ann Oncol. 1998 Sep;9(9):939–950. doi: 10.1023/A:1008389021382. [DOI] [PubMed] [Google Scholar]
  10. Glanz K., Grove J., Lerman C., Gotay C., Le Marchand L. Correlates of intentions to obtain genetic counseling and colorectal cancer gene testing among at-risk relatives from three ethnic groups. Cancer Epidemiol Biomarkers Prev. 1999 Apr;8(4 Pt 2):329–336. [PubMed] [Google Scholar]
  11. Glanz K., Resch N., Lerman C., Rimer B. K. Black-white differences in factors influencing mammography use among employed female health maintenance organization members. Ethn Health. 1996 Sep;1(3):207–220. doi: 10.1080/13557858.1996.9961789. [DOI] [PubMed] [Google Scholar]
  12. Goodkind D. M. New zodiacal influences on Chinese family formation: Taiwan, 1976. Demography. 1993 May;30(2):127–142. [PubMed] [Google Scholar]
  13. Handelman L., Menahem S., Eisenbruch I. M. Transcultural understanding of a hereditary disorder. Mucopolysaccharidosis VI in a Vietnamese family. Clin Pediatr (Phila) 1989 Oct;28(10):470–473. doi: 10.1177/000992288902801009. [DOI] [PubMed] [Google Scholar]
  14. Huang X., Butow P., Meiser B., Goldstein D. Attitudes and information needs of Chinese migrant cancer patients and their relatives. Aust N Z J Med. 1999 Apr;29(2):207–213. doi: 10.1111/j.1445-5994.1999.tb00685.x. [DOI] [PubMed] [Google Scholar]
  15. Hughes C., Gomez-Caminero A., Benkendorf J., Kerner J., Isaacs C., Barter J., Lerman C. Ethnic differences in knowledge and attitudes about BRCA1 testing in women at increased risk. Patient Educ Couns. 1997 Sep-Oct;32(1-2):51–62. doi: 10.1016/s0738-3991(97)00064-5. [DOI] [PubMed] [Google Scholar]
  16. Hughes C., Lerman C., Lustbader E. Ethnic differences in risk perception among women at increased risk for breast cancer. Breast Cancer Res Treat. 1996;40(1):25–35. doi: 10.1007/BF01806000. [DOI] [PubMed] [Google Scholar]
  17. Inoue R., Fukutomi T., Ushijima T., Matsumoto Y., Sugimura T., Nagao M. Germline mutation of BRCA1 in Japanese breast cancer families. Cancer Res. 1995 Aug 15;55(16):3521–3524. [PubMed] [Google Scholar]
  18. Lerman C., Hughes C., Benkendorf J. L., Biesecker B., Kerner J., Willison J., Eads N., Hadley D., Lynch J. Racial differences in testing motivation and psychological distress following pretest education for BRCA1 gene testing. Cancer Epidemiol Biomarkers Prev. 1999 Apr;8(4 Pt 2):361–367. [PubMed] [Google Scholar]
  19. Lesjak M., Hua M., Ward J. Cervical screening among immigrant Vietnamese women seen in general practice: current rates, predictors and potential recruitment strategies. Aust N Z J Public Health. 1999 Apr;23(2):168–173. doi: 10.1111/j.1467-842x.1999.tb01229.x. [DOI] [PubMed] [Google Scholar]
  20. Lipkus I. M., Iden D., Terrenoire J., Feaganes J. R. Relationships among breast cancer concern, risk perceptions, and interest in genetic testing for breast cancer susceptibility among African-American women with and without a family history of breast cancer. Cancer Epidemiol Biomarkers Prev. 1999 Jun;8(6):533–539. [PubMed] [Google Scholar]
  21. McCaul K. D., Branstetter A. D., Schroeder D. M., Glasgow R. E. What is the relationship between breast cancer risk and mammography screening? A meta-analytic review. Health Psychol. 1996 Nov;15(6):423–429. doi: 10.1037//0278-6133.15.6.423. [DOI] [PubMed] [Google Scholar]
  22. Morton M. S., Griffiths K., Blacklock N. The preventive role of diet in prostatic disease. Br J Urol. 1996 Apr;77(4):481–493. doi: 10.1046/j.1464-410x.1996.09361.x. [DOI] [PubMed] [Google Scholar]
  23. Nguyen M. T., Swenson I. Variations in Vietnamese marriages, births and infant deaths by months of the Julian calendar and years of the Vietnamese and Chinese astrological calendars. J Biosoc Sci. 1996 Jul;28(3):367–377. doi: 10.1017/s0021932000022434. [DOI] [PubMed] [Google Scholar]
  24. Phillips K. A., Warner E., Meschino W. S., Hunter J., Abdolell M., Glendon G., Andrulis I. L., Goodwin P. J. Perceptions of Ashkenazi Jewish breast cancer patients on genetic testing for mutations in BRCA1 and BRCA2. Clin Genet. 2000 May;57(5):376–383. doi: 10.1034/j.1399-0004.2000.570508.x. [DOI] [PubMed] [Google Scholar]
  25. Pugh J. F. Astrological counseling in contemporary India. Cult Med Psychiatry. 1983 Sep;7(3):279–299. doi: 10.1007/BF00049314. [DOI] [PubMed] [Google Scholar]
  26. Staniszewska S., Ahmed L., Jenkinson C. The conceptual validity and appropriateness of using health-related quality of life measures with minority ethnic groups. Ethn Health. 1999 Feb-May;4(1-2):51–63. doi: 10.1080/13557859998191. [DOI] [PubMed] [Google Scholar]
  27. Tang N. L., Pang C. P., Yeo W., Choy K. W., Lam P. K., Suen M., Law L. K., King W. W., Johnson P., Hjelm M. Prevalence of mutations in the BRCA1 gene among Chinese patients with breast cancer. J Natl Cancer Inst. 1999 May 19;91(10):882–885. doi: 10.1093/jnci/91.10.882. [DOI] [PubMed] [Google Scholar]
  28. Wang Vivian, Marsh Frank H. Ethical principles and cultural integrity in health care delivery: Asian ethnocultural perspectives in genetic services. J Genet Couns. 1992 Mar;1(1):81–92. doi: 10.1007/BF00960087. [DOI] [PubMed] [Google Scholar]
  29. Westbrook M. T., Legge V., Pennay M. Attitudes towards disabilities in a multicultural society. Soc Sci Med. 1993 Mar;36(5):615–623. doi: 10.1016/0277-9536(93)90058-c. [DOI] [PubMed] [Google Scholar]
  30. Yuen S. T., Chung L. P., Leung S. Y., Luk I. S., Chan S. Y., Ho J. C., Ho J. W., Wyllie A. H. Colorectal carcinoma in Hong Kong: epidemiology and genetic mutations. Br J Cancer. 1997;76(12):1610–1616. doi: 10.1038/bjc.1997.605. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Medical Genetics are provided here courtesy of BMJ Publishing Group

RESOURCES