Psychosocial impact of breast/ovarian (BRCA1/2) cancer-predictive genetic testing in a UK multi-centre clinical cohort.
Morrison, P J
Evans, D Gareth R
AffiliationDepartment of Psychological Medicine, Royal Marsden NHS Foundation Trust, London & Sutton, SM2 5PT, England. Maggie.Watson@rmh.nthames.nhs.uk
MetadataShow full item record
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.
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. Cancer
JournalBritish Journal of Cancer
- Predictive genetic testing for BRCA1/2 in a UK clinical cohort: three-year follow-up.
- Authors: Foster C, Watson M, Eeles R, Eccles D, Ashley S, Davidson R, Mackay J, Morrison PJ, Hopwood P, Evans DG, Psychosocial Study Collaborators.
- Issue date: 2007 Mar 12
- Men at risk of being a mutation carrier for hereditary breast/ovarian cancer: an exploration of attitudes and psychological functioning during genetic testing.
- Authors: Lodder L, Frets PG, Trijsburg RW, Tibben A, Meijers-Heijboer EJ, Duivenvoorden HJ, Wagner A, van Der Meer CA, Devilee P, Cornelisse CJ, Niermeijer MF
- Issue date: 2001 Jul
- Predictive testing for BRCA1/2: attributes, risk perception and management in a multi-centre clinical cohort.
- Authors: Foster C, Evans DG, Eeles R, Eccles D, Ashley S, Brooks L, Davidson R, Mackay J, Morrison PJ, Watson M
- Issue date: 2002 Apr 22
- BRCA1 testing in families with hereditary breast-ovarian cancer. A prospective study of patient decision making and outcomes.
- Authors: Lerman C, Narod S, Schulman K, Hughes C, Gomez-Caminero A, Bonney G, Gold K, Trock B, Main D, Lynch J, Fulmore C, Snyder C, Lemon SJ, Conway T, Tonin P, Lenoir G, Lynch H
- Issue date: 1996 Jun 26
- Diagnostic genetic testing for hereditary breast and ovarian cancer in cancer patients: women's looking back on the pre-test period and a psychological evaluation.
- Authors: Claes E, Evers-Kiebooms G, Boogaerts A, Decruyenaere M, Denayer L, Legius E
- Issue date: 2004 Spring