title: Breast cancer genetic counselling referrals: how comparable are the findings between the UK and the Netherlands?
abstract: Counselees from different countries may differ in demographic and medical characteristics and this could affect their pre-counselling cognitions and psychosocial variables. Research outcomes may therefore not be easily transferable between countries. To examine this, a cross-national comparison of UK (West Midlands: WM) and Dutch (Middle Netherlands: MN) counselees in breast cancer genetic counselling was conducted. Two hundred thirty-eight WM and 156 MN proband counselees were compared on demographics, breast cancer history and referral pathways. Multivariate logistic regression analyses were performed to check whether national differences in knowledge of breast cancer and heredity, risk perception, worry and information needs persisted when corrected for the background characteristics. About half of the Dutch compared to 8% of UK counselees were affected by breast cancer. More UK than Dutch counselees were at high risk from hereditary breast cancer. UK counselees had higher risk perceptions and more knowledge about breast cancer prevalence, but these differences lost significance when corrected for counselees' risk levels and other background characteristics. Counselees from the UK might report higher levels of worry than Dutch counselees and this could not be explained by their background characteristics. Comparisons of findings between the UK and the Netherlands show that the UK seems to have a higher percentage of high-risk referrals and these counselees seem to have higher risk perceptions. Irrespective of their actual risk level, UK counselees might be more worried. Comparing findings between the different countries raises questions about how transferable research findings are from one culture to another.
authors: NIVEL (Netherlands Institute for Health Services Research), P.O. Box 1568, 3500 BN, Utrecht, the Netherlands, a.albada@nivel.nl.
authors: Akke
authors: A
authors: Albada
authors: Julie
authors: J
authors: Werrett
authors: Sandra
authors: S
authors: Van Dulmen
authors: Jozien M
authors: JM
authors: Bensing
authors: Cyril
authors: C
authors: Chapman
authors: Margreet G E M
authors: MG
authors: Ausems
authors: Alison
authors: A
authors: Metcalfe