Psychosocial impact of breast/ovarian (BRCA1/2) cancer-predictive genetic testing in a UK multi-centre clinical cohort.

2.50
Hdl Handle:
http://hdl.handle.net/10541/77858
Title:
Psychosocial impact of breast/ovarian (BRCA1/2) cancer-predictive genetic testing in a UK multi-centre clinical cohort.
Authors:
Watson, M; Foster, C; Eeles, Rosalind; Eccles, D; Ashley, Sue; Davidson, R; Mackay, J; Morrison, P J; Hopwood, Penelope; Evans, D Gareth R
Abstract:
This multi-centre UK study assesses the impact of predictive testing for breast and ovarian cancer predisposition genes (BRCA1/2) in the clinical context. In the year following predictive testing, 261 adults (59 male) from nine UK genetics centres participated; 91 gene mutation carriers and 170 noncarriers. Self-report questionnaires were completed at baseline (pre-genetic testing) and 1, 4 and 12 months following the genetic test result. Men were assessed for general mental health (by general health questionnaire (GHQ)) and women for general mental health, cancer-related worry, intrusive and avoidant thoughts, perception of risk and risk management behaviour. Main comparisons were between female carriers and noncarriers on all measures and men and women for general mental health. Female noncarriers benefited psychologically, with significant reductions in cancer-related worry following testing (P<0.001). However, younger female carriers (<50 years) showed a rise in cancer-related worry 1 month post-testing (P<0.05). This returned to pre-testing baseline levels 12 months later, but worry remained significantly higher than noncarriers throughout (P<0.01). There were no significant differences in GHQ scores between males and females (both carriers and noncarriers) at any time point. Female carriers engaged in significantly more risk management strategies than noncarriers in the year following testing (e.g. mammograms; 92% carriers vs 30% noncarriers). In the 12 months post-testing, 28% carriers had bilateral risk-reducing mastectomy and 31% oophorectomy. Oophorectomy was confined to older (mean 41 yrs) women who already had children. However, worry about cancer was not assuaged by surgery following genetic testing, and this requires further investigation. In all, 20% of female carriers reported insurance problems. The data show persistent worry in younger female gene carriers and confirm changes in risk management consistent with carrier status. Men were not adversely affected by genetic testing in terms of their general mental health.
Affiliation:
Department of Psychological Medicine, Royal Marsden NHS Foundation Trust, London & Sutton, SM2 5PT, England. Maggie.Watson@rmh.nthames.nhs.uk
Citation:
Psychosocial impact of breast/ovarian (BRCA1/2) cancer-predictive genetic testing in a UK multi-centre clinical cohort. 2004, 91 (10):1787-94 Br. J. Cancer
Journal:
British Journal of Cancer
Issue Date:
15-Nov-2004
URI:
http://hdl.handle.net/10541/77858
DOI:
10.1038/sj.bjc.6602207
PubMed ID:
15505627
Type:
Article
Language:
en
ISSN:
0007-0920
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorWatson, M-
dc.contributor.authorFoster, C-
dc.contributor.authorEeles, Rosalind-
dc.contributor.authorEccles, D-
dc.contributor.authorAshley, Sue-
dc.contributor.authorDavidson, R-
dc.contributor.authorMackay, J-
dc.contributor.authorMorrison, P J-
dc.contributor.authorHopwood, Penelope-
dc.contributor.authorEvans, D Gareth R-
dc.date.accessioned2009-08-19T13:46:31Z-
dc.date.available2009-08-19T13:46:31Z-
dc.date.issued2004-11-15-
dc.identifier.citationPsychosocial impact of breast/ovarian (BRCA1/2) cancer-predictive genetic testing in a UK multi-centre clinical cohort. 2004, 91 (10):1787-94 Br. J. Canceren
dc.identifier.issn0007-0920-
dc.identifier.pmid15505627-
dc.identifier.doi10.1038/sj.bjc.6602207-
dc.identifier.urihttp://hdl.handle.net/10541/77858-
dc.description.abstractThis multi-centre UK study assesses the impact of predictive testing for breast and ovarian cancer predisposition genes (BRCA1/2) in the clinical context. In the year following predictive testing, 261 adults (59 male) from nine UK genetics centres participated; 91 gene mutation carriers and 170 noncarriers. Self-report questionnaires were completed at baseline (pre-genetic testing) and 1, 4 and 12 months following the genetic test result. Men were assessed for general mental health (by general health questionnaire (GHQ)) and women for general mental health, cancer-related worry, intrusive and avoidant thoughts, perception of risk and risk management behaviour. Main comparisons were between female carriers and noncarriers on all measures and men and women for general mental health. Female noncarriers benefited psychologically, with significant reductions in cancer-related worry following testing (P<0.001). However, younger female carriers (<50 years) showed a rise in cancer-related worry 1 month post-testing (P<0.05). This returned to pre-testing baseline levels 12 months later, but worry remained significantly higher than noncarriers throughout (P<0.01). There were no significant differences in GHQ scores between males and females (both carriers and noncarriers) at any time point. Female carriers engaged in significantly more risk management strategies than noncarriers in the year following testing (e.g. mammograms; 92% carriers vs 30% noncarriers). In the 12 months post-testing, 28% carriers had bilateral risk-reducing mastectomy and 31% oophorectomy. Oophorectomy was confined to older (mean 41 yrs) women who already had children. However, worry about cancer was not assuaged by surgery following genetic testing, and this requires further investigation. In all, 20% of female carriers reported insurance problems. The data show persistent worry in younger female gene carriers and confirm changes in risk management consistent with carrier status. Men were not adversely affected by genetic testing in terms of their general mental health.en
dc.language.isoenen
dc.subjectBreast Canceren
dc.subjectOvarian Canceren
dc.subject.meshAdult-
dc.subject.meshAge Factors-
dc.subject.meshAnxiety-
dc.subject.meshBreast Neoplasms-
dc.subject.meshCohort Studies-
dc.subject.meshFemale-
dc.subject.meshGenes, BRCA1-
dc.subject.meshGenes, BRCA2-
dc.subject.meshGenetic Predisposition to Disease-
dc.subject.meshGenetic Screening-
dc.subject.meshGreat Britain-
dc.subject.meshHeterozygote-
dc.subject.meshHumans-
dc.subject.meshInsurance Selection Bias-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshMutation-
dc.subject.meshOvarian Neoplasms-
dc.subject.meshQuestionnaires-
dc.subject.meshRisk Management-
dc.subject.meshSex Factors-
dc.titlePsychosocial impact of breast/ovarian (BRCA1/2) cancer-predictive genetic testing in a UK multi-centre clinical cohort.en
dc.typeArticleen
dc.contributor.departmentDepartment of Psychological Medicine, Royal Marsden NHS Foundation Trust, London & Sutton, SM2 5PT, England. Maggie.Watson@rmh.nthames.nhs.uken
dc.identifier.journalBritish Journal of Canceren

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