title: Impact on survivors of retinoblastoma when informed of study results on risk of second cancers.
abstract: BACKGROUND
  To assess the impact of providing research feedback to retinoblastoma survivors or their parents regarding the risk of second cancers.
  
  
  METHODS
  A four-page survey was sent to 801 retinoblastoma survivors and 55 parents to ascertain their reactions to a "results-letter." The "results-letter" provided feedback from a study indicating that retinoblastoma survivors may be at increased risk of second cancers.
  
  
  RESULTS
  Three hundred and thirty-nine (339) retinoblastoma survivors and 43 parents responded to the survey. Eighty-four percent (84%) of respondents found the "results-letter" "very" to "extremely" understandable and 72% found it "very" to "extremely" useful. Participants scored "very" to "extremely" to the following emotions: frightened = 28%, anxious = 27%, sad = 25%, overwhelmed = 15%, angry = 11%, and guilty = 6%. Five (1.4%) respondents stated that they would have preferred not to receive the results. Responses did not vary significantly between survivors with different risks of second cancers. No significant differences were observed between males and females. However, parents were significantly more likely to report feelings of anxiety, guilt, anger, being overwhelmed, and frightened compared to adult retinoblastoma survivors (P < 0.05). Individuals with less than a college education were significantly more sad, angry, overwhelmed, and frightened by the information than individuals with a college degree or higher (P < 0.05). Eighteen percent (18%) of all respondents shared the feedback with their physician. The method of choice for receiving results was by letter with contact names and phone numbers.
  
  
  CONCLUSIONS
  These findings indicate that research participants want feedback even when the information is upsetting. Additional studies are needed to identify individuals who experience greater levels of distress following feedback in an attempt to provide improved methods of feedback and support.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
authors.forename: Charlene J
authors.initials: CJ
authors.lastname: Schulz
authors.forename: Mary P
authors.initials: MP
authors.lastname: Riddle
authors.forename: Heiddis B
authors.initials: HB
authors.lastname: Valdimirsdottir
authors.forename: David H
authors.initials: DH
authors.lastname: Abramson
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sklar
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005190:Family / Q000523:psychology*; D005246:Feedback; D005260:Female; D006167:Guilt; D006801:Humans; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D009519:New York City / Q000453:epidemiology; D019572:Retinal Neoplasms / Q000523:psychology* / Q000532:radiotherapy; D012175:Retinoblastoma / Q000523:psychology* / Q000532:radiotherapy; D012307:Risk Factors; D012509:Sarcoma / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*