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

Psychosocial impact of breast/ovarian (BRCA1/2) cancer-predictive genetic testing in a UK multi-centre clinical cohort
Psychosocial impact of breast/ovarian (BRCA1/2) cancer-predictive genetic testing in a UK multi-centre clinical cohort
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.
predictive genetic testing, worry, risk management, psychosocial issues, brca1/2, cancer-predictive genetic testing
0007-0920
1787-1794
Watson, M.
168c5230-279a-4c51-9065-eefcd18191fa
Foster, C.
00786ac1-bd47-4aeb-a0e2-40e058695b73
Eeles, R.
c7ae2359-6f49-4f42-88f8-a241570f9d4f
Eccles, D.
ab92515c-365a-4b0b-90ef-1bafb4b7bd9a
Ashley, S.
e742da83-3a74-4c9c-9d79-3993a69f3660
Davidson, R.
9f684474-a989-4d8c-988c-a42e3d19db25
Mackay, J.
8a2363bb-013c-415a-ba9b-77aee80d1002
Morrison, P.J.
cdcdba90-397b-4345-b409-7e2d1e1282d4
Hopwood, P.
aed6184b-149a-4459-b68e-87a9e22241f0
Evans, D.G.R.
2fd1ea41-abdf-4d13-a2a3-afa9ba2f4c12
Watson, M.
168c5230-279a-4c51-9065-eefcd18191fa
Foster, C.
00786ac1-bd47-4aeb-a0e2-40e058695b73
Eeles, R.
c7ae2359-6f49-4f42-88f8-a241570f9d4f
Eccles, D.
ab92515c-365a-4b0b-90ef-1bafb4b7bd9a
Ashley, S.
e742da83-3a74-4c9c-9d79-3993a69f3660
Davidson, R.
9f684474-a989-4d8c-988c-a42e3d19db25
Mackay, J.
8a2363bb-013c-415a-ba9b-77aee80d1002
Morrison, P.J.
cdcdba90-397b-4345-b409-7e2d1e1282d4
Hopwood, P.
aed6184b-149a-4459-b68e-87a9e22241f0
Evans, D.G.R.
2fd1ea41-abdf-4d13-a2a3-afa9ba2f4c12

Watson, M., Foster, C., Eeles, R., Eccles, D., Ashley, S., Davidson, R., Mackay, J., Morrison, P.J., Hopwood, P. and Evans, D.G.R. (2004) Psychosocial impact of breast/ovarian (BRCA1/2) cancer-predictive genetic testing in a UK multi-centre clinical cohort. British Journal of Cancer, 91 (10), 1787-1794. (doi:10.1038/sj.bjc.6602207).

Record type: Article

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.

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More information

Published date: 2004
Keywords: predictive genetic testing, worry, risk management, psychosocial issues, brca1/2, cancer-predictive genetic testing
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 26658
URI: http://eprints.soton.ac.uk/id/eprint/26658
ISSN: 0007-0920
PURE UUID: 50414a67-f491-491e-938d-562c91b578dc
ORCID for C. Foster: ORCID iD orcid.org/0000-0002-4703-8378

Catalogue record

Date deposited: 11 Apr 2006
Last modified: 03 Dec 2019 01:48

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