title: Genetic testing for melanoma risk: a prospective cohort study of uptake and outcomes among Australian families.
abstract: OBJECTIVE
  The aim of this prospective cohort study was to examine uptake and psychological, behavioral, and cognitive outcomes of genetic testing for melanoma risk among individuals with a known family-specific CDKN2A mutation.
  
  
  METHODS
  A total of 119 individuals were ascertained via a genetic epidemiological study and completed a series of mailed, self-administered questionnaires at multiple time points, including notification of genetic test availability, and 2 weeks and 12 months after receipt of genetic test results (for "test participants"), or 12 months after notification (for "decliners").
  
  
  RESULTS
  Since January 2005, 21% of participants (n = 25) have undergone genetic testing, with 75% of those who have received results identified as mutation carriers (n = 15). Factors associated with uptake of genetic counseling included perceived susceptibility to melanoma (odds ratio = 3.60, P = 0.0008), and fatalistic beliefs about melanoma (odds ratio = 0.57, P = 0.005). Compared with baseline, carriers reported significantly reduced anxiety scores at 2 weeks, and reduced depression scores at 2 weeks and 12 months, after receipt of genetic test results. Carriers also reported a significantly greater frequency of clinical skin examination at 12-month follow-up compared with decliners (chi2 = 5.70, P = 0.02). No hypothesis testing was carried out for noncarriers because of their limited number.
  
  
  CONCLUSIONS
  These data provide preliminary evidence for healthy psychological, behavioral, and cognitive adjustment after participation in genetic testing for melanoma risk.
authors.affiliation: School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia. N.Kasparian@unsw.edu.au
authors.forename: Nadine A
authors.initials: NA
authors.lastname: Kasparian
authors.forename: Bettina
authors.initials: B
authors.lastname: Meiser
authors.forename: Phyllis N
authors.initials: PN
authors.lastname: Butow
authors.forename: Judy M
authors.initials: JM
authors.lastname: Simpson
authors.forename: Graham J
authors.initials: GJ
authors.lastname: Mann
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000235:genetics; D005192:Family Health; D005260:Female; D005817:Genetic Counseling / Q000379:methods*; D005820:Genetic Testing; D006579:Heterozygote; D006801:Humans; D016015:Logistic Models; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000235:genetics* / Q000523:psychology; D008875:Middle Aged; D009154:Mutation; D011446:Prospective Studies; D012307:Risk Factors; D012923:Social Class; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D019941:Cyclin-Dependent Kinase Inhibitor p16