title: Prognostic factors for hereditary cancer distress six months after BRCA1/2 or HNPCC genetic susceptibility testing.
abstract: This study explored predictors for hereditary cancer distress six months after genetic susceptibility testing for a known familial BRCA1/2 or HNPCC related mutation, in order to gain insight into aspects relevant for the identification of individuals needing additional psychosocial support. Coping, illness representations, experiences with cancer in relatives and family system characteristics were assessed in 271 applicants for genetic testing before result disclosure. Hereditary cancer distress was assessed prospectively up to six months after disclosure. Regression analysis revealed that the pretest level of distress, complicated grief, the number of affected first-degree relatives and strong emotional illness representations were factors that best explained hereditary cancer distress. Other significant predictors were illness coherence, passive coping, distraction seeking, being aged <13 years when a parent was affected by cancer and family communication. Individuals who may benefit from additional support may be identified before result disclosure using a short instrument assessing the relevant aspects.
authors.affiliation: Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Westzeedijk 112-114, 3016 AH, Rotterdam, The Netherlands. i.vanoostrom@erasmusmc.nl
authors.forename: Iris
authors.initials: I
authors.lastname: van Oostrom
authors.forename: Hanne
authors.initials: H
authors.lastname: Meijers-Heijboer
authors.forename: Hugo J
authors.initials: HJ
authors.lastname: Duivenvoorden
authors.forename: Annette H J T
authors.initials: AH
authors.lastname: Bröcker-Vriends
authors.forename: Christi J
authors.initials: CJ
authors.lastname: van Asperen
authors.forename: Rolf H
authors.initials: RH
authors.lastname: Sijmons
authors.forename: Caroline
authors.initials: C
authors.lastname: Seynaeve
authors.forename: Arthur R
authors.initials: AR
authors.lastname: Van Gool
authors.forename: Jan G M
authors.initials: JG
authors.lastname: Klijn
authors.forename: Aad
authors.initials: A
authors.lastname: Tibben
mesh_terms: D000328:Adult; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000235:genetics / Q000523:psychology*; D030881:Disclosure; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease / Q000235:genetics / Q000523:psychology*; D005820:Genetic Testing / Q000523:psychology*; D006801:Humans; D008297:Male; D009154:Mutation / Q000235:genetics; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D013315:Stress, Psychological / Q000209:etiology*