Inequalities in Genetic Services for Hereditary Breast and Ovarian Cancer: A Bibliometric and Thematic Analysis
This review aimed to examine the inequalities in access to genetic counseling and testing services among individuals with Hereditary Breast and Ovarian Cancer Syndrome (HBOC) using bibliometric and thematic analysis methods. In this mixed methods study, conducted using an explanatory sequential design, 421 articles published in the Web of Science database between 1997 and 2025 were first analyzed bibliometrically. In the second stage, thematic analysis was conducted on the 10 most cited studies. Bibliometric findings indicate that scientific production in this field has increased significantly since 2013, with studies conducted primarily by US-based institutions and supported by strong international collaborations. Thematic analysis identified four main themes: (1) inequities in access to and participation in services, (2) differences in clinical outcomes, (3) changes in service delivery models, and (4) communication barriers. Findings revealed that inequities in access to genetic services under HBOC are related not only to individual awareness or economic status but also to systemic and cultural factors. Furthermore, remote (telephone) genetic counseling has been shown to have the potential to reduce geographic and structural barriers. Consequently, culturally tailored, accessible, and multidisciplinary approaches to addressing health disparities in HBOC are needed. Future research is recommended to compare experiences across countries using multiple data sources. This study demonstrates that nurses play a crucial role in facilitating access to genetic counseling and testing services for individuals at risk for hereditary cancer. Strengthening nurses' genetic literacy, cultural sensitivity, and equity-based care approaches will increase service accessibility and the effectiveness of holistic care.
