title: Genetic testing in familial melanoma: uptake and implications.
abstract: OBJECTIVE
  We report on the uptake and psychological impact of p16-Leiden genetic testing to contribute to a greater understanding of counseling melanoma families.
  
  
  METHODS
  Within a defined research setting, genetic counseling and testing were offered to members of p16-Leiden-positive melanoma pedigrees, at risk of carrying a gene defect associated with an increased risk of melanoma and pancreatic cancer.
  
  
  RESULTS
  One hundred and eighty-four individuals sought counseling, of which 141 (77%) opted for genetic testing. Uptake of genetic counseling and testing, and psychological motivation was evaluated in 94 (57%) individuals. Higher pre-test risk of carrying the mutation and older age proved significantly predictive for counseling uptake. Age was predictive for test acceptance, whereas fearful test expectancies predicted test decline. Counselees had lower distress levels than those reported in other oncogenetic testing settings.
  
  
  CONCLUSIONS
  We are the first to report on genetic testing for familial melanoma. Following the first counseling session, we found a relatively high uptake rate for p16-Leiden testing and no clinically worrisome levels of distress.
authors.affiliation: Department of Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Femke A
authors.initials: FA
authors.lastname: de Snoo
authors.forename: Samantha R
authors.initials: SR
authors.lastname: Riedijk
authors.forename: Anneke M
authors.initials: AM
authors.lastname: van Mil
authors.forename: Wilma
authors.initials: W
authors.lastname: Bergman
authors.forename: Jeanet A C
authors.initials: JA
authors.lastname: ter Huurne
authors.forename: Reinier
authors.initials: R
authors.lastname: Timman
authors.forename: Wieke
authors.initials: W
authors.lastname: Bertina
authors.forename: Nelleke A
authors.initials: NA
authors.lastname: Gruis
authors.forename: Hans F A
authors.initials: HF
authors.lastname: Vasen
authors.forename: Arie
authors.initials: A
authors.lastname: van Haeringen
authors.forename: Martijn H
authors.initials: MH
authors.lastname: Breuning
authors.forename: Aad
authors.initials: A
authors.lastname: Tibben
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001290:Attitude; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D005239:Fear; D005260:Female; D019942:Genes, p16; D005817:Genetic Counseling; D005820:Genetic Testing / Q000379:methods*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000235:genetics* / Q000523:psychology; D008875:Middle Aged; D009042:Motivation; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000235:genetics*; D010375:Pedigree; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000235:genetics*; D055815:Young Adult