title: Population testing for cancer predisposing BRCA1/BRCA2 mutations in the Ashkenazi-Jewish community: a randomized controlled trial.
abstract: BACKGROUND
  Technological advances raise the possibility of systematic population-based genetic testing for cancer-predisposing mutations, but it is uncertain whether benefits outweigh disadvantages. We directly compared the psychological/quality-of-life consequences of such an approach to family history (FH)-based testing.
  
  
  METHODS
  In a randomized controlled trial of BRCA1/2 gene-mutation testing in the Ashkenazi Jewish (AJ) population, we compared testing all participants in the population screening (PS) arm with testing those fulfilling standard FH-based clinical criteria (FH arm). Following a targeted community campaign, AJ participants older than 18 years were recruited by self-referral after pretest genetic counseling. The effects of BRCA1/2 genetic testing on acceptability, psychological impact, and quality-of-life measures were assessed by random effects regression analysis. All statistical tests were two-sided.
  
  
  RESULTS
  One thousand, one hundred sixty-eight AJ individuals were counseled, 1042 consented, 1034 were randomly assigned (691 women, 343 men), and 1017 were eligible for analysis. Mean age was 54.3 (SD = 14.66) years. Thirteen BRCA1/2 carriers were identified in the PS arm, nine in the FH arm. Five more carriers were detected among FH-negative FH-arm participants following study completion. There were no statistically significant differences between the FH and PS arms at seven days or three months on measures of anxiety, depression, health anxiety, distress, uncertainty, and quality-of-life. Contrast tests indicated that overall anxiety (P = .0001) and uncertainty (P = .005) associated with genetic testing decreased; positive experience scores increased (P = .0001); quality-of-life and health anxiety did not change with time. Overall, 56% of carriers did not fulfill clinical criteria for genetic testing, and the BRCA1/2 prevalence was 2.45%.
  
  
  CONCLUSIONS
  Compared with FH-based testing, population-based genetic testing in Ashkenazi Jews doesn't adversely affect short-term psychological/quality-of-life outcomes and may detect 56% additional BRCA carriers.
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Ranjit
authors.initials: R
authors.lastname: Manchanda
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Kelly
authors.initials: K
authors.lastname: Loggenberg
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Saskia
authors.initials: S
authors.lastname: Sanderson
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Matthew
authors.initials: M
authors.lastname: Burnell
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Sue
authors.initials: S
authors.lastname: Gessler
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Lucy
authors.initials: L
authors.lastname: Side
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Nyala
authors.initials: N
authors.lastname: Balogun
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Rakshit
authors.initials: R
authors.lastname: Desai
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Ajith
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Huw
authors.initials: H
authors.lastname: Dorkins
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Wallis
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Cyril
authors.initials: C
authors.lastname: Chapman
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Rohan
authors.initials: R
authors.lastname: Taylor
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Chris
authors.initials: C
authors.lastname: Jacobs
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Ian
authors.initials: I
authors.lastname: Tomlinson
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Alistair
authors.initials: A
authors.lastname: McGuire
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Uziel
authors.initials: U
authors.lastname: Beller
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ).
authors.forename: Usha
authors.initials: U
authors.lastname: Menon
authors.affiliation: Affiliation of authors: Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK (RM, KL, MB, SG, LS, NB, RD, UM, IJ); Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK (RM); Mount Sinai School of Medicine, New York, NY (SS); Behavioral Sciences Unit, Department of Epidemiology and Public Health, University College London, London, UK (JW); Department of Clinical Genetics, North East Thames Regional Genetics Unit, Great Ormond Street Hospital, London, UK (AK); Department of Clinical Genetics, North West Thames Regional Genetics Unit, Northwick Park Hospital, London, UK (HD); West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK (YW); Department of Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK (CC); South West Thames Molecular Genetics Diagnostic Laboratory, St George's Hospital, London, UK (RT); Department of Clinical Genetics, Guy's Hospital, London, UK (CJ); London Research Institute, Cancer Research UK (IT); Department of Health Economics, London School of Economics, London, UK (AM); Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel (UB); Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester, UK (IJ). ian.jacobs@manchester.ac.uk.
authors.forename: Ian
authors.initials: I
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D003661:Decision Support Techniques; D003863:Depression / Q000209:etiology; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D018703:Founder Effect; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D006579:Heterozygote; D006801:Humans; D007585:Jews / Q000235:genetics*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009154:Mutation; D009369:Neoplasms / Q000235:genetics* / Q000523:psychology*; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D013315:Stress, Psychological / Q000209:etiology; D013997:Time Factors
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human