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Banerjee SC, Sussman A, Schofield E, Guest DD, Dailey YS, Schwartz MR, Buller DB, Hunley K, Kaphingst K, Berwick M, Hay JL. "Let's Talk about Skin Cancer": Examining Association between Family Communication about Skin Cancer, Perceived Risk, and Sun Protection Behaviors. JOURNAL OF HEALTH COMMUNICATION 2021; 26:576-585. [PMID: 34612176 PMCID: PMC8513818 DOI: 10.1080/10810730.2021.1966686] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Family communication about skin cancer risk may motivate protective behaviors. However, it is unclear how widespread such communication might be. In this study, we describe prevalence and patterns (across environmental, personal, and behavioral factors) of family communication about skin cancer across N = 600 diverse (79% female, 48% Hispanic, 44% non-Hispanic White) primary care patients from Albuquerque, New Mexico, a geographical location with year-round sun exposure. Over half reported discussing general cancer (77%) and skin cancer risks (66%) with their families. The most frequent target of skin cancer risk communication included doctors (54%), followed by friends/coworkers (49%), spouse/partner (43%), other family members (38%), sisters (36%), mothers (36%), daughters (33%), sons (32%), father (24%), and brothers (22%). On average, participants reported having talked to three family members about skin cancer risks. The most frequently discussed content of skin cancer risk communication was the use of sun protection (89%), followed by the personal risk of skin cancer (68%), who had skin cancer in the family (60%), family risk of skin cancer (59%), time of sun exposure (57%), and skin cancer screening (57%). A family or personal history of cancer, higher perceived risk, higher health literacy, being non-Hispanic, having higher education or income, and proactive sun protective behavior were associated with greater family communication about general cancer and skin cancer risks. These study findings have implications for interventions that encourage discussions about skin cancer risk, sun protection, and skin cancer screening that lead to adoption of sun-safe behaviors.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Kim Kaphingst
- University of Utah, Huntsman Cancer Center, Salt Lake City, UT, USA
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Primiero CA, Yanes T, Finnane A, Soyer HP, McInerney-Leo AM. A Systematic Review on the Impact of Genetic Testing for Familial Melanoma I: Primary and Secondary Preventative Behaviours. Dermatology 2021; 237:806-815. [PMID: 33588421 DOI: 10.1159/000513919] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 12/12/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Increasing availability of panel testing for known high-penetrance familial melanoma genes has made it possible to improve risk awareness in those at greatest risk. Prior to wider implementation, the role of genetic testing in preventing melanoma, through influencing primary and secondary preventative behaviours, requires clarification. METHODS Database searches of PubMed, Embase, CINAHL, PsycINFO and the Cochrane Library were conducted for studies describing preventative behaviour outcomes in response to genetic testing for melanoma risk. Publications describing original research of any study type were screened for eligibility. RESULTS Eighteen publications describing 11 unique studies were reviewed. Outcomes assessed are based on health behaviour recommendations for those at increased risk: adherence to sun-protective behaviour (SPB); clinical skin examinations (CSE); skin self-examinations (SSE); and family discussion of risk. Overall, modest increases in adherence to primary prevention strategies of SPB were observed following genetic testing. Importantly, there were no net decreases in SPB found amongst non-carriers. For secondary preventative behaviour outcomes, including CSE and SSE, increases in post-test intentions and long-term adherence were reported across several subgroups in approximately half of the studies. While this increase reached significance in mutation carriers in some studies, one study reported a significant decline in annual CSE adherence of non-mutation carriers. CONCLUSIONS Evidence reviewed suggests that genetic testing has a modestly positive impact on preventative behaviour in high-risk individuals. Furthermore, improvements are observed regardless of mutation carrier status, although greater adherence is found in carriers. While additional studies of more diverse cohorts would be needed to inform clinical recommendations, the findings are encouraging and suggest that genetic testing for melanoma has a positive impact on preventative behaviours.
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Affiliation(s)
- Clare A Primiero
- The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Queensland, Australia
| | - Tatiane Yanes
- The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Queensland, Australia
| | - Anna Finnane
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - H Peter Soyer
- The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Queensland, Australia,
- Department of Dermatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia,
| | - Aideen M McInerney-Leo
- The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Queensland, Australia
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Robinson J, Spring B. Personalized melanoma genomic risk information:perception of shared risk initiates sharing with family. Br J Dermatol 2017; 177:890-891. [DOI: 10.1111/bjd.15862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J.K. Robinson
- Department of Dermatology; Northwestern University Feinberg School of Medicine; Chicago IL U.S.A
| | - B. Spring
- Department of Preventive Medicine; Northwestern University Feinberg School of Medicine; Chicago IL U.S.A
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Smit A, Keogh L, Newson A, Butow P, Dunlop K, Morton R, Kirk J, Espinoza D, Cust A. Does personalized melanoma genomic risk information trigger conversations about skin cancer prevention and skin examination with family, friends and health professionals? Br J Dermatol 2017. [DOI: 10.1111/bjd.15744] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- A.K. Smit
- Cancer Epidemiology and Prevention Research Sydney School of Public Health The University of Sydney Australia
- Centre for Values Ethics and the Law in Medicine Sydney School of Public Health The University of Sydney Australia
| | - L.A. Keogh
- Melbourne School of Population and Global Health The University of Melbourne Australia
| | - A.J. Newson
- Centre for Values Ethics and the Law in Medicine Sydney School of Public Health The University of Sydney Australia
| | - P.N. Butow
- Centre for Medical Psychology and Evidence‐based Decision‐making School of Psychology The University of Sydney Australia
| | - K. Dunlop
- The Centre for Genetics Education NSW Health Sydney Australia
| | - R.L. Morton
- NHMRC Clinical Trials Centre The University of Sydney Australia
- Melanoma Institute Australia The University of Sydney Australia
| | - J. Kirk
- Westmead Clinical School and Westmead Institute for Medical Research Sydney Medical School The University of Sydney Australia
| | - D. Espinoza
- NHMRC Clinical Trials Centre The University of Sydney Australia
| | - A.E. Cust
- Cancer Epidemiology and Prevention Research Sydney School of Public Health The University of Sydney Australia
- Melanoma Institute Australia The University of Sydney Australia
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Smit AK, Espinoza D, Newson AJ, Morton RL, Fenton G, Freeman L, Dunlop K, Butow PN, Law MH, Kimlin MG, Keogh LA, Dobbinson SJ, Kirk J, Kanetsky PA, Mann GJ, Cust AE. A Pilot Randomized Controlled Trial of the Feasibility, Acceptability, and Impact of Giving Information on Personalized Genomic Risk of Melanoma to the Public. Cancer Epidemiol Biomarkers Prev 2016; 26:212-221. [PMID: 27702805 DOI: 10.1158/1055-9965.epi-16-0395] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 09/15/2016] [Accepted: 09/24/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Communication of personalized melanoma genomic risk information may improve melanoma prevention behaviors. METHODS We evaluated the feasibility and acceptability of communicating personalized genomic risk of melanoma to the public and its preliminary impact on behaviors and psychosocial outcomes. One hundred eighteen people aged 22 to 69 years provided a saliva sample and were randomized to the control (nonpersonalized educational materials) or intervention (personalized booklet presenting melanoma genomic risk as absolute and relative risks and a risk category based on variants in 21 genes, telephone-based genetic counseling, and nonpersonalized educational materials). Intention-to-treat analyses overall and by-risk category were conducted using ANCOVA adjusted for baseline values. RESULTS Consent to participate was 41%, 99% were successfully genotyped, and 92% completed 3-month follow-up. Intervention participants reported high satisfaction with the personalized booklet (mean = 8.6, SD = 1.6; on a 0-10 scale) and genetic counseling (mean = 8.1, SD = 2.2). No significant behavioral effects at 3-month follow-up were identified between intervention and control groups overall: objectively measured standard erythemal doses per day [-16%; 95% confidence interval (CI), -43% to 24%] and sun protection index (0.05; 95% CI, -0.07 to 0.18). There was increased confidence identifying melanoma at 3 months (0.40; 95% CI, 0.10-0.69). Stratified by risk category, effect sizes for intentional tanning and some individual sun protection items appeared stronger for the average-risk group. There were no appreciable group differences in skin cancer-related worry or psychologic distress. CONCLUSIONS Our results demonstrate feasibility and acceptability of providing personalized genomic risk of melanoma to the public. IMPACT Genomic risk information has potential as a melanoma prevention strategy. Cancer Epidemiol Biomarkers Prev; 26(2); 212-21. ©2016 AACR.
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Affiliation(s)
- Amelia K Smit
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia
| | - David Espinoza
- NHMRC Clinical Trials Centre, The University of Sydney, Australia
| | - Ainsley J Newson
- Centre for Values, Ethics and the Law in Medicine, Sydney School of Public Health, The University of Sydney, Australia
| | - Rachael L Morton
- NHMRC Clinical Trials Centre, The University of Sydney, Australia
| | - Georgina Fenton
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia.,The Centre for Genetics Education, NSW Health, Sydney, Australia
| | - Lucinda Freeman
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia.,The Centre for Genetics Education, NSW Health, Sydney, Australia
| | - Kate Dunlop
- The Centre for Genetics Education, NSW Health, Sydney, Australia
| | - Phyllis N Butow
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, The University of Sydney, Australia
| | - Matthew H Law
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Michael G Kimlin
- The University of the Sunshine Coast and Cancer Council Queensland, Brisbane, Australia
| | - Louise A Keogh
- Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | | | - Judy Kirk
- Westmead Clinical School, and Westmead Institute for Medical Research, Sydney Medical School, The University of Sydney, Australia
| | - Peter A Kanetsky
- Cancer Epidemiology Program, Moffitt Cancer Center, Tampa, Florida
| | - Graham J Mann
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Australia.,Melanoma Institute Australia, The University of Sydney, Australia
| | - Anne E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia. .,Melanoma Institute Australia, The University of Sydney, Australia
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