Conceptualising the imapct of genetic testing on cancer disparities in the USA

Testing for germ-line mutations offers a predictive tool of hereditary cancer risk with the promise of future benefits to the US healthcare system and its consumers. Based on the few studies on genetic testing for cancer, awareness and uptake appear to be lower among racial/ethnic minorities. The sources of variation need to be understood for ethical reasons and for more successful technology diffusion in the broader population. We conceptualise a framework for the impact of genetic testing on disparities, as defined by the 2003 Institute of Medicine report on unequal treatment. We further extend this framework by discussing the bi-directional process of immigrant adjustment into a host country. Overall, we argue that genetic testing operating under the prevailing healthcare system will widen disparities, adverse effects of discrimination by providers and insurers will become more pronounced, but increased understanding of acculturation's effect on immigrants may promote more effective consumption of genetic testing and diffusion of awareness.