Background: Little is known about barriers to Hereditary Breast and Ovarian Cancer (HBOC) genetic counseling among
Puerto Rican women.
Objective: This study reviews existing literature to identify individual, interpersonal, and systems level factors that may
impact the use of HBOC genetic services among Puerto Rican women living in the United States.
Methods: A systematic search of articles published between the years 1995-2014 was performed in PubMed and ISI Web
of Science. Additionally, the bibliography of relevant articles was reviewed for additional potential articles.
Results: Individual level barriers most frequently identified included: a lack of knowledge or awareness about HBOC or
genetic counseling and testing, and facilitators included high levels of interest in genetic counseling/genetic testing. Interpersonal
level barriers included worry about knowing a family member’s risk, and conversely, a facilitator was the ability
to help family members. Systems level barriers included concerns about the cost, having competing life demands, whereas
facilitators included holding private insurance.
Conclusion: Puerto Rican women are a unique ethnic minority group with specific perceptions, beliefs and levels of education
about genetic counseling and testing for HBOC. Addressing individual, interpersonal and systems level factors
unique to this group may improve knowledge and awareness. Policy and structural changes may be needed to improve
system level barriers.