title: Experience of parental cancer in childhood is a risk factor for psychological distress during genetic cancer susceptibility testing.
abstract: BACKGROUND
  This study explores the effect of age at the time of parental cancer diagnosis or death on psychological distress and cancer risk perception in individuals undergoing genetic testing for a specific cancer susceptibility.
  
  
  METHODS
  Cancer-related distress, worry and risk perception were assessed in 271 applicants for genetic testing of an identified mutation in BRCA1/2 (BReast CAncer) or a HNPCC (Hereditary Nonpolyposis Colorectal Cancer) related gene before, one week after, and six months after genetic test disclosure. The course of distress and risk perception were compared between individuals having witnessed parental cancer or loss due to cancer in childhood, adolescence, adulthood and having unaffected parents.
  
  
  RESULTS
  Individuals with parental cancer in childhood (under age 13) reported the highest level of cancer related distress, worry and risk perception. Women having their mother affected by breast cancer in puberty (aged 10-13 years) perceived higher breast cancer risks than women with an affected mother in adulthood or without an affected mother. Individuals with an affected parent perceived cancer risks as higher than individuals without an affected parent, but were not more distressed.
  
  
  CONCLUSIONS
  Experience of parental cancer in childhood is a risk factor for psychological distress during the genetic testing process.
authors.affiliation: Department of Clinical Genetics, Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands. i.vanoostrom@erasmusmc.nl
authors.forename: I
authors.initials: I
authors.lastname: van Oostrom
authors.forename: H
authors.initials: H
authors.lastname: Meijers-Heijboer
authors.forename: H J
authors.initials: HJ
authors.lastname: Duivenvoorden
authors.forename: A H J T
authors.initials: AH
authors.lastname: Bröcker-Vriends
authors.forename: C J
authors.initials: CJ
authors.lastname: van Asperen
authors.forename: R H
authors.initials: RH
authors.lastname: Sijmons
authors.forename: C
authors.initials: C
authors.lastname: Seynaeve
authors.forename: A R
authors.initials: AR
authors.lastname: Van Gool
authors.forename: J G M
authors.initials: JG
authors.lastname: Klijn
authors.forename: A
authors.initials: A
authors.lastname: Tibben
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D002648:Child; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D004252:DNA Mutational Analysis / Q000523:psychology; D005260:Female; D005820:Genetic Testing / Q000523:psychology*; D006801:Humans; D008297:Male; D010290:Parents; D011627:Puberty; D018570:Risk Assessment