title: Moderators of cancer-related distress and worry after a pancreatic cancer genetic counseling and screening intervention.
abstract: OBJECTIVE
  Although the hereditary breast and ovarian cancer literature has demonstrated short-term gains in psychological adjustment following genetic counseling, there has been limited research examining long-term outcomes and moderators. Moreover, there has been minimal research into the psychological effects of this intervention in populations at high risk for pancreatic cancer. This study examines the long-term effects of pancreatic cancer screening and genetic counseling on cancer-related distress and cancer worry in a high-risk population at 1-year follow-up. Additionally, this study explores potential moderators of the effectiveness of this intervention.
  
  
  METHODS
  One hundred twenty-nine participants with familial pancreatic cancer or with the BRCA2 gene mutation completed a baseline questionnaire prior to their first pancreatic cancer screening and genetic counseling session. Participants also completed questionnaires at 3- and 12-month follow-up.
  
  
  RESULTS
  Cancer-related intrusive thoughts decreased significantly over time, whereas cancer-related worry decreased at 3 months and showed a small but significant increase at 1 year. Age and baseline distress exhibited moderator effects. Younger individuals showed a significant decrease in cancer-related intrusive thoughts, cancer-related avoidant thoughts, and cancer worry. Additionally, individuals with greater baseline distress showed a significant decrease in cancer-related intrusive thoughts over time.
  
  
  CONCLUSIONS
  Analysis of the long-term effects of pancreatic cancer screening and genetic testing reveal psychological gains that are maintained at 1-year follow-up. This intervention is particularly effective for younger participants and individuals with greater baseline distress.
authors.affiliation: Ryerson University, Psychology, Toronto, Ontario, Canada. stacey.hart@psych.ryerson.ca
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Hart
authors.forename: Lindsey A
authors.initials: LA
authors.lastname: Torbit
authors.forename: Cassandra J
authors.initials: CJ
authors.lastname: Crangle
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Esplen
authors.forename: Spring
authors.initials: S
authors.lastname: Holter
authors.forename: Kara
authors.initials: K
authors.lastname: Semotiuk
authors.forename: Ayelet
authors.initials: A
authors.lastname: Borgida
authors.forename: Paola
authors.initials: P
authors.lastname: Ardiles
authors.forename: Heidi
authors.initials: H
authors.lastname: Rothenmund
authors.forename: Steve
authors.initials: S
authors.lastname: Gallinger
mesh_terms: D000223:Adaptation, Psychological; D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics* / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000523:psychology*; D001294:Attitude to Health; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D024522:Genes, BRCA2; D005817:Genetic Counseling / Q000523:psychology*; D020022:Genetic Predisposition to Disease / Q000523:psychology; D005820:Genetic Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000523:psychology; D010465:Perception; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires