title: Risk reduction behaviors and provider communication following genetic counseling and BRCA1 mutation testing in an African American kindred.
abstract: Little is known about the impact of cancer genetic counseling and testing on health behaviors in racial and ethnic subgroups. This prospective observational study examined use of risk reduction strategies following BRCA1 counseling and testing. Participants were female members of an African American kindred who received genetic education, counseling and testing (n = 40) and completed a 1-year follow-up interview. Mutation carriers were more likely to opt for breast (100%, 7/7) and ovarian (25%; 1 of 4) cancer surveillance than prophylactic surgery. Following genetic counseling, 71% (5/7) of the BRCA1 carriers who opted for surveillance reported having a mammogram within the year following receipt of their genetic test results. Ovarian cancer screening among mutation carriers increased from 0% at baseline to 25% (one of four) at 1 year. Compared to noncarriers (23%, 7/30), carriers (70%, 7/10) were more likely to discuss their BRCA1 test results with their primary health care providers. Surveillance for breast cancer was preferred to prophylactic surgery and chemoprevention as a way to reduce risk for these cancers. Our data indicate that patient-provider communication about BRCA1 test results is suboptimal.
authors.affiliation: Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA. anita.kinney@hci.utah.edu
authors.forename: Anita Yeomans
authors.initials: AY
authors.lastname: Kinney
authors.forename: Sara Ellis
authors.initials: SE
authors.lastname: Simonsen
authors.forename: Bonnie Jeanne
authors.initials: BJ
authors.lastname: Baty
authors.forename: Diptasri
authors.initials: D
authors.lastname: Mandal
authors.forename: Susan L
authors.initials: SL
authors.lastname: Neuhausen
authors.forename: Kate
authors.initials: K
authors.lastname: Seggar
authors.forename: Richard
authors.initials: R
authors.lastname: Holubkov
authors.forename: Lindsey
authors.initials: L
authors.lastname: Bloor
authors.forename: Ken
authors.initials: K
authors.lastname: Smith
mesh_terms: D000328:Adult; D044383:Black People / Q000235:genetics* / Q000523:psychology; D001943:Breast Neoplasms / Q000235:genetics*; D002755:Choice Behavior; D003142:Communication; D004252:DNA Mutational Analysis; D005260:Female; D019398:Genes, BRCA1; D006580:Genetic Carrier Screening; D005817:Genetic Counseling; D005820:Genetic Testing / Q000523:psychology*; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008403:Mass Screening / Q000523:psychology; D008875:Middle Aged; D019370:Observation; D010051:Ovarian Neoplasms / Q000235:genetics / Q000523:psychology; D011446:Prospective Studies; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D001741:Black or African American