BRCA1/2 testing in hereditary breast and ovarian cancer families III: risk perception and screening.
This study aimed to ascertain whether cancer risk perception changed following the offer and subsequent receipt of BRCA1/2 results and to evaluate breast and ovarian screening practices in testers and non-testers. Members of thirteen HBOC families were offered BRCA1/2 testing for a known family mutation. Perceived risk for developing breast cancer, ovarian cancer or for carrying the familial BRCA1/2 mutation, was assessed at baseline and again at 6-9 months following the receipt of test results. Breast and ovarian cancer screening data were obtained at both time-points. A total of 138 women participated and 120 (87%) chose to be tested for a known familial mutation. Twenty-eight women (24%) were identified as carriers and their perceived ovarian cancer risk and their perception of being a mutation carrier increased (P = 0.01 for both). Those testing negatives had a significant decrease in all dimensions of risk perception (P < 0.01). Regression analysis showed test results to be strong predictors of follow-up risk perception (P = 0.001), however, they were not predictors of screening practices at follow-up. Testers were more likely to have completed a clinical breast exam following testing than decliners. Mammography was positively associated with baseline adherence, age, and intrusive thoughts. Ovarian cancer worries only predicted pelvic ultrasound screening post-testing. Baseline practices and psychological factors appear to be stronger predictors of health behavior than test results.
McInerney-Leo
Aideen
A
Genetic Disease Research Branch, NHGRI, Bethesda, Maryland 20892-0249, USA.
Hadley
Donald
D
Kase
Ronald G
RG
Giambarresi
Therese R
TR
Struewing
Jeffery P
JP
Biesecker
Barbara Bowles
BB
D000328:Adult; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology*; D005260:Female; D005820:Genetic Testing / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010051:Ovarian Neoplasms / Q000235:genetics / Q000523:psychology*; D012044:Regression Analysis; D018570:Risk Assessment; D011795:Surveys and Questionnaires
D019313:BRCA1 Protein; D024682:BRCA2 Protein