Adherence to Recommended Risk Management among Unaffected Women with a BRCA Mutation.
Identifying unaffected women with a BRCA mutation can have a significant individual and population health impact on morbidity and mortality if these women adhere to guidelines for managing cancer risk. But, little is known about whether such women are adherent to current guidelines. We conducted telephone surveys of 97 unaffected BRCA mutation carriers who had genetic counseling at least one year prior to the survey to assess adherence to current guidelines, factors associated with adherence, and common reasons for performing and not performing recommended risk management. More than half of participants reported being adherent with current risk management recommendations for breast cancer (69 %, n = 67), ovarian cancer (82 %, n = 74) and both cancers (66 %, n = 64). Older age (OR = 10.53, p = 0.001), white race (OR = 8.93, p = 0.019), higher breast cancer genetics knowledge (OR = 1.67, p = 0.030), higher cancer-specific distress (OR = 1.07, p = 0.002) and higher physical functioning (OR = 1.09, p = 0.009) were significantly associated with adherence to recommended risk management for both cancers. Responses to open-ended questions about reasons for performing and not performing risk management behaviors indicated that participants recognized the clinical utility of these behaviors. Younger individuals and those with lower physical functioning may require targeted interventions to improve adherence, perhaps in the setting of long-term follow-up at a multi-disciplinary hereditary cancer clinic.
Geisinger Health System, Genomic Medicine Institute, M.C. 26-20, 100 N. Academy Ave, Danville, PA, 17822, USA. ahbuchanan@geisinger.edu.
Adam H
AH
Buchanan
Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, USA.|Department of Medicine, Duke University Medical Center, Durham, NC, USA.
Corrine I
CI
Voils
Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA.
Joellen M
JM
Schildkraut
Department of Genetics, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA.
Catherine
C
Fine
Massachusetts General Hospital Biostatistics Center, Boston, MA, USA.
Nora K
NK
Horick
Department of Medicine, Duke University Medical Center, Durham, NC, USA.|Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA.
P Kelly
PK
Marcom
Division of Cellular Therapy, Duke University Medical Center, Durham, NC, USA.
Kristi
K
Wiggins
Department of Clinical Sciences and Harold C Simmons Cancer Center, University of Texas - Southwestern, Dallas, TX, USA.
Celette Sugg
CS
Skinner
D000328:Adult; D001943:Breast Neoplasms / Q000235:genetics*; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D009154:Mutation; D010051:Ovarian Neoplasms / Q000235:genetics*; D040242:Risk Reduction Behavior
BRCA1 gene; BRCA2 gene; Breast cancer; Genetic counseling; Ovarian cancer