The impact of receiving genetic test results on general and cancer-specific psychologic distress among members of an African-American kindred with a BRCA1 mutation.
BACKGROUND
Numerous studies have examined short-term and long-term psychologic responses to genetic testing for breast/ovarian carcinoma susceptibility in clinic samples and among families who participated in genetic linkage studies. However, to the authors' knowledge, the vast majority of studies focused on non-Latino whites and women. In this prospective study, the authors investigated the psychologic impact of receiving carrier-specific BRCA1 test results as part of a genetic education/counseling intervention in female and male members of an African-American kindred with a BRCA1 mutation.


METHODS
Eighty-five of 101 participating kindred members (84%) underwent genetic counseling/education and testing according to an established protocol. Participants completed in-person or telephone-administered, computer-assisted interviews. At baseline and after the receipt of test results (1 mo, 4 mos, and 12 mos), general psychologic distress (i.e., anxiety and depression) and cancer-specific distress were measured. Statistical analyses were performed using linear mixed-model approaches for longitudinal data.


RESULTS
The hypothesis that mutation carriers, particularly women who had no personal history of breast carcinoma, were expected to report greater distress than noncarriers was not supported. After controlling for socioeconomic status and personal history of breast/ovarian carcinoma, noncarriers reported significant declines in the distress measures (depressive symptoms, anxiety and cancer-related worries), whereas distress was not altered markedly in carriers after genetic risk notification.


CONCLUSIONS
The current findings suggested that individuals receiving BRCA1 test results who learn that they are not carriers of a deleterious mutation may experience psychologic benefits. Furthermore, those who learned that they were mutation carriers did not appear to have adverse, clinically meaningful psychologic outcomes.
Kinney
Anita Yeomans
AY
Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA. anita.kinney@hci.utah.edu
Bloor
Lindsey E
LE
Mandal
Diptasri
D
Simonsen
Sara Ellis
SE
Baty
Bonnie Jeanne
BJ
Holubkov
Richard
R
Seggar
Kate
K
Neuhausen
Susan
S
Smith
Ken
K
D000223:Adaptation, Psychological; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D019943:Amino Acid Substitution; D001007:Anxiety; D001294:Attitude to Health; D019313:BRCA1 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology; D003863:Depression; D005190:Family; D005260:Female; D006801:Humans; D007182:Income; D008875:Middle Aged; D020125:Mutation, Missense; D010051:Ovarian Neoplasms / Q000235:genetics / Q000523:psychology; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States
D019313:BRCA1 Protein