title: Advanced cancer patients' attitudes towards, and experiences with, screening for somatic mutations in tumours: a qualitative study.
abstract: Somatic mutations in key oncogenes in non-small cell lung cancer (NSCLC) and melanoma are important determinants of tumour sensitivity to targeted therapies. Molecular screening for these predictive biomarkers is routinely used to inform treatment decisions; however, little is known about how best to communicate testing and results to patients. This qualitative study aimed to explore advanced cancer patients' attitudes and experiences regarding somatic tumour screening to identify their information and support needs. Sixteen NSCLC and eight melanoma patients who had undergone screening participated in a semi-structured face-to-face or telephone interview exploring their understanding, views, preferences and needs regarding screening. Interviews were audiotaped, transcribed and analysed for thematic patterns. Participants expressed positive views and unequivocal acceptance of screening, and understood its role in guiding treatment selection. They preferred to receive information verbally through simple, non-technical language from their oncologist with additional take-home materials. Patients were interested in learning about their test results, but wanted discussion to be focused on practical matters relevant to treatment. While receiving their screening results was not considered burdensome, information overload and cancer-related distress were identified as barriers to test comprehension. Patients may benefit from information and decision-related tools to better understand genomic information and adequately support psychosocial outcomes.
authors.affiliation: UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Liang
authors.affiliation: Psychosocial Research Group, Prince of Wales Clinical School, Sydney, NSW, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Meiser
authors.affiliation: Psychosocial Research Group, Prince of Wales Clinical School, Sydney, NSW, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Smith
authors.affiliation: Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.
authors.forename: N A
authors.initials: NA
authors.lastname: Kasparian
authors.affiliation: Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW, Australia.|Prince of Wales Clinical School, Randwick, NSW, Australia.
authors.forename: C R
authors.initials: CR
authors.lastname: Lewis
authors.affiliation: Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW, Australia.|Prince of Wales Clinical School, Randwick, NSW, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Chin
authors.affiliation: Melanoma Institute of Australia, The University of Sydney, Mater and Royal North Shore Hospital, Sydney, NSW, Australia.
authors.forename: G V
authors.initials: GV
authors.lastname: Long
authors.affiliation: Prince of Wales Clinical School, Randwick, NSW, Australia.|University of Queensland, Brisbane, QLD, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Ward
authors.affiliation: Melanoma Institute of Australia, The University of Sydney, Mater and Royal North Shore Hospital, Sydney, NSW, Australia.
authors.forename: A M
authors.initials: AM
authors.lastname: Menzies
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors.forename: J N
authors.initials: JN
authors.lastname: Harris-Wai
authors.affiliation: Psychosocial Research Group, Prince of Wales Clinical School, Sydney, NSW, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Kaur
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics / Q000473:pathology / Q000523:psychology*; D005260:Female; D005820:Genetic Testing; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics / Q000473:pathology / Q000523:psychology*; D008297:Male; D008545:Melanoma / Q000235:genetics / Q000473:pathology / Q000523:psychology*; D008875:Middle Aged; D010353:Patient Education as Topic; D057285:Precision Medicine / Q000379:methods / Q000523:psychology*; D036301:Qualitative Research
keywords: genetic testing; lung cancer; melanoma; qualitative; somatic mutation screening; tumour testing