title: Psychological distress related to BRCA testing in ovarian cancer patients.
abstract: An increasing demand for genetic testing has moved the procedure from highly selected at-risk individuals, now also including cancer patients for treatment associated testing. The heritable fraction of ovarian cancer is more than 10%, and our department has offered BRCA testing to such patients irrespective of family history since 2002. This study examined potential psychosocial distress associated with this procedure using The Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire and other patient-rated generic distress instruments. Patients were divided into four groups according to cancer risk: mutation carriers, own history of breast cancer and ovarian cancer, family history of breast cancer and/or ovarian cancer, and patients without family history. In a postal survey, 354 patients responded. Good acceptance of the MICRA was observed, and previously described good psychometric properties were confirmed. A significant association between MICRA total score and receiving a positive BRCA test result was found. No significant between-group differences were observed with generic distress instruments. Time since cancer diagnosis, test result, and survey showed no significant associations with MICRA scores. Internal consistencies of instruments were adequate. Exploratory and confirmatory factor analyses showed adequate fit indices for a three factor solution of the MICRA, but further refinement of the items should be considered. In conclusion, the specific types of worry and distress most relevant to receiving genetic testing irrespective of family history were not captured by the generic distress instruments. The MICRA was supported as a useful tool for detection of mental distress related to genetic testing and risk evaluation.
authors.affiliation: Department of Molecular Oncology, Institute for Cancer Research, Oslo University Hospital, Norwegian Radium Hospital, PO Box 4953 Nydalen, 0424, Oslo, Norway. meretebj@ulrik.uio.no.|Faculty of Medicine, University of Oslo, Oslo, Norway. meretebj@ulrik.uio.no.
authors.forename: Merete
authors.identifier: http://orcid.org/0000-0002-1788-2869
authors.initials: M
authors.lastname: Bjørnslett
authors.affiliation: Faculty of Medicine, University of Oslo, Oslo, Norway.|Department of Oncology, National Advisory Center for Late Effects after Cancer Treatment, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway.
authors.forename: Alv A
authors.initials: AA
authors.lastname: Dahl
authors.affiliation: School of Business and Social Sciences, Buskerud and Vestfold University College, Hønefoss, Norway.
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Sørebø
authors.affiliation: Department of Gynecologic Oncology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway.
authors.forename: Anne
authors.initials: A
authors.lastname: Dørum
mesh_terms: D000368:Aged; D001007:Anxiety / Q000235:genetics; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D011379:Prognosis; D018570:Risk Assessment; D013315:Stress, Psychological / Q000235:genetics*
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human
keywords: Anxiety; BRCA; MICRA; Oncology; Ovarian cancer