Ethnic Differences in the Frequency of Cancer Reported from Family Pedigrees in the Prenatal Genetic Counseling Setting
This study analyzed if differences in cancer reporting exist between different ethnic groups when collecting family pedigrees in a prenatal genetic counseling setting. Data was collected from 446 prenatal charts at University of California, Irvine from January 1, 2015 – August 31, 2020. A total of 795 pedigrees meeting inclusion criteria (409 maternal pedigrees and 386 paternal pedigrees) were analyzed from four ethnic groups: non-Hispanic White, Hispanic/Latino(a), Asian, and African American/Black. The total number of first- and second-degree relatives and number of these relatives affected with cancer were calculated for each pedigree and analyzed using contingency tables, non-parametric tests, and Poisson regression. Cancer reporting in first- and second-degree relatives was the highest among the non-Hispanic White group. Reporting of a family history of cancer was lower in Hispanics, Asians, and African Americans. Ethnicity was a significant factor in predicting the number of relatives reported to have cancer in a Poisson regression model (controlling for the total number of relatives in the pedigree). The incidence of cancer reported in the pedigrees for Hispanics, African Americans, and Asians was 36.3%, 50.2%, and 65.5% (respectively) of the incidence seen in the non-Hispanic White pedigrees. The cancer reporting differences observed in the Asian pedigrees are similar to differences in population incidence as reported by the CDC, but the reporting in the Hispanic and African American pedigrees is less than would be expected based on population incidence. This suggests that cancer histories in some minority populations may be truncated. Genetic counselors should recognize that certain patient populations may be at risk for limited knowledge of a family cancer history. The study also identified that cancer reporting in the paternal family history was significantly increased when the father was present, and that a family history of cancer was under-reported in questionnaires completed prior to clinic. In order to provide appropriate risk assessment, staff should encourage patients to obtain family cancer and health history ahead of their appointment, since the prenatal clinic may be the only time a comprehensive family health history is obtained.