title: Characterizing biased cancer-related cognitive processing: relationships with BRCA1/2 genetic mutation status, personal cancer history, age, and prophylactic surgery.
abstract: OBJECTIVE
  This study evaluated associations of cancer-related cognitive processing with BRCA1/2 mutation carrier status, personal cancer history, age, and election of prophylactic surgery in women at high risk for breast cancer.
  
  
  METHODS
  In a 2 (BRCA1/2 mutation carrier status) × 2 (personal cancer history) matched-control design, with age as an additional predictor, participants (N = 115) completed a computerized cancer Stroop task. Dependent variables were response latency to cancer-related stimuli (reaction time [RT]) and cancer-related cognitive interference (cancer RT minus neutral RT). RT and interference were tested as predictors of prophylactic surgery in the subsequent four years.
  
  
  RESULTS
  RT for cancer-related words was significantly slower than other word groups, indicating biased processing specific to cancer-related stimuli. Participants with a cancer history evidenced longer RT to cancer-related words than those without a history; moreover, a significant Cancer History × Age interaction indicated that, among participants with a cancer history, the typical advantage associated with younger age on Stroop tasks was absent. BRCA mutation carriers demonstrated more cancer-related cognitive interference than noncarriers. Again, the typical Stroop age advantage was absent among carriers. Exploratory analyses indicated that BRCA+ status and greater cognitive interference predicted greater likelihood of undergoing prophylactic surgery. Post hoc tests suggest that cancer-related distress does not account for these relationships.
  
  
  CONCLUSIONS
  In the genetic testing context, younger women with a personal cancer history or who are BRCA1/2 mutation carriers might be particularly vulnerable to biases in cancer-related cognitive processing. Biased processing was associated marginally with greater likelihood of prophylactic surgery.
authors.affiliation: Department of Psychiatry, The Ohio State University.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Carpenter
authors.affiliation: Department of Psychology, University of Southern California.
authors.forename: Stacy
authors.initials: S
authors.lastname: Eisenberg
authors.affiliation: Department of Psychology, American University.
authors.forename: Sharone
authors.initials: S
authors.lastname: Weltfreid
authors.affiliation: Department of Psychiatry, University of Pittsburgh.
authors.forename: Carissa A
authors.initials: CA
authors.lastname: Low
authors.affiliation: Department of Psychology.
authors.forename: Tammy
authors.initials: T
authors.lastname: Beran
authors.affiliation: Department of Psychology.
authors.forename: Annette L
authors.initials: AL
authors.lastname: Stanton
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control / Q000523:psychology* / Q000601:surgery; D003071:Cognition; D003657:Decision Making; D005260:Female; D005544:Forecasting; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease / Q000523:psychology*; D005820:Genetic Testing; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D015141:Los Angeles; D008408:Mastectomy / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D009154:Mutation; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control / Q000523:psychology* / Q000601:surgery; D010052:Ovariectomy / Q000523:psychology / Q000706:statistics & numerical data; D011930:Reaction Time; D018570:Risk Assessment; D057190:Stroop Test