Abstract B020: Communication patterns among Black hereditary cancer patients and their families about cascade testing

Abstract Background: Family communication about hereditary breast and ovarian cancer (HBOC) genetic testing is critical for increasing cascade testing among at-risk relatives. Black patients face disproportionately high cancer mortality rates, frequently associated with delayed diagnoses and insufficient genetic testing. A persistent myth suggests that Black families rarely discuss cancer; however, research specifically addressing hereditary cancer communications in these families remains limited. Purpose: The purpose of this exploratory qualitative study was to analyze communication patterns among Black HBOC patients and their families regarding genetic testing results, cancer screening, and prevention strategies, particularly cascade testing. Methods: We conducted a secondary analysis of interview transcripts (n=5) from interviews with Black female HBOC probands using Foucauldian Discourse Analysis (FDA). Results: Contrary to assumptions that Black families avoid cancer discussions, our findings reveal that Black families do discuss cancer and cascade testing, but communication varied based on familial relationships, gender dynamics, and social context. Probands often experienced emotional strain, balancing the responsibility of informing family members against fears of burdening loved ones. Some preferred seeking external emotional and social support to avoid overwhelming family members, particularly in scenarios involving hierarchical family roles. Additionally, privileges such as access to trusted healthcare teams, genetic testing education, and less financial toxicity facilitated more open family discussions and encouraged relatives to pursue cascade testing. Conclusion: These insights highlight the need for interventions designed to support communication about genetic risk and cascade testing in Black families, addressing gender-specific barriers and enhancing communicative competence. Efforts must include educational outreach to improve understanding and reduce stigma surrounding genetic testing. Given the association between BRCA mutations and prostate cancer risk and inherited nature of HBOC regardless of gender, future research efforts should increase the inclusion of men for more comprehensive family health communications. Citation Format: Lynette Hammond Gerido, Katrina Ellis, Elizabeth Onyekwere, Kirsten Riggan, Megan Allyse. Communication patterns among Black hereditary cancer patients and their families about cascade testing [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B020.