Subjective versus objective risk in genetic counseling for hereditary breast and/or ovarian cancers.
BACKGROUND
Despite the fact that genetic counseling in oncology provides information regarding objective risks, it can be found a contrast between the subjective and objective risk. The aims of this study were to evaluate the accuracy of the perceived risk compared to the objective risk estimated by the BRCApro computer model and to evaluate any associations between medical, demographic and psychological variables and the accuracy of risk perception.


METHODS
130 subjects were given medical-demographic file, Cancer and Genetic Risk Perception, Hospital Anxiety-Depression Scale. It was also computed an objective evaluation of the risk by the BRCApro model.


RESULTS
The subjective risk was significantly higher than objective risk. The risk of tumour was overestimated by 56%, and the genetic risk by 67%. The subjects with less cancer affected relatives significantly overestimated their risk of being mutation carriers and made a more inaccurate estimation than high risk subjects.


CONCLUSIONS
The description of this sample shows: general overestimation of the risk, inaccurate perception compared to BRCApro calculation and a more accurate estimation in those subjects with more cancer affected relatives (high risk subjects). No correlation was found between the levels of perception of risk and anxiety and depression. Based on our findings, it is worth pursuing improved communication strategies about the actual cancer and genetic risk, especially for subjects at "intermediate and slightly increased risk" of developing an hereditary breast and/or ovarian cancer or of being mutation carrier.
Caruso
Anita
A
Prevention and Training Activities in Psycho-Oncology, National Cancer Institute Regina Elena, Rome, Italy. caruso@ifo.it
Vigna
Cristina
C
Marozzo
Bruna
B
Sega
Fabio M
FM
Sperduti
Isabella
I
Cognetti
Francesco
F
Savarese
Antonella
A
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology*; D018567:Breast Neoplasms, Male / Q000235:genetics / Q000523:psychology; D005260:Female; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics / Q000523:psychology*; D010465:Perception; D012306:Risk; D018570:Risk Assessment; D055815:Young Adult