title: Differences between women who pursued genetic testing for hereditary breast and ovarian cancer and their at-risk relatives who did not.
abstract: OBJECTIVE
  To (a) examine differences in appraisals of hereditary breast and ovarian cancer (HBOC), psychological distress, family environment, and decisional conflict between women who pursued genetic testing and their at-risk relatives who did not, and (b) examine correlations among appraisals of HBOC, psychological distress, family environment, and decisional conflict regarding genetic testing in these two cohorts of women.
  
  
  METHODS
  Descriptive, cross-sectional cohort study.
  
  
  METHODS
  Two clinics affiliated with a major research university in the midwestern United States.
  
  
  METHODS
  372 women aged 18 years and older. 200 pursued genetic testing for BRCA1 and BRCA2 mutations (probands) and 172 of their female relatives who had a greater than 10% prior probability of being a mutation carrier but had not pursued testing.
  
  
  METHODS
  After providing informed consent, probands and relatives were mailed self-administered questionnaires.
  
  
  METHODS
  Perceived risk, knowledge of HBOC risk factors and modes of gene inheritance, perceived severity, perceived controllability, psychological distress, family relationships, family communication, and decisional conflict about genetic testing.
  
  
  RESULTS
  T tests revealed that probands perceived higher risk and had more psychological distress associated with breast cancer. Probands had more knowledge regarding risk factors and gene inheritance, and greater decisional conflict regarding genetic testing. Relatives reported higher perceived severity and controllability. No differences were observed in family relationships and family communication between probands and relatives. Pearson correlations revealed different patterns in knowledge, perceived controllability, family relationships, and decisional conflict between probands and relatives.
  
  
  CONCLUSIONS
  Significant differences exist between women who pursue genetic testing and those who do not. The family environment influences adjustment to HBOC and decisions about genetic testing.
  
  
  CONCLUSIONS
  Enhancing the family communication process about HBOC can provide informational and emotional support to high-risk women and promote decision making about genetic testing.
authors.affiliation: School of Nursing, University of Michigan, Ann Arbor, USA. mkatapo@umich.edu
authors.forename: Maria C
authors.initials: MC
authors.lastname: Katapodi
authors.forename: Laurel
authors.initials: L
authors.lastname: Northouse
authors.forename: Penny
authors.initials: P
authors.lastname: Pierce
authors.forename: Kara J
authors.initials: KJ
authors.lastname: Milliron
authors.forename: Guipeng
authors.initials: G
authors.lastname: Liu
authors.forename: Sofia D
authors.initials: SD
authors.lastname: Merajver
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000235:genetics* / Q000523:psychology; D015331:Cohort Studies; D003220:Conflict, Psychological; D003430:Cross-Sectional Studies; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease / Q000523:psychology; D005820:Genetic Testing / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000523:psychology; D018570:Risk Assessment; D055815:Young Adult