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Seales CL, Puri D, Yodkhunnatham N, Pandit K, Yuen K, Murray S, Smitham J, Lafin JT, Bagrodia A. Advancing GCT Management: A Review of miR-371a-3p and Other miRNAs in Comparison to Traditional Serum Tumor Markers. Cancers (Basel) 2024; 16:1379. [PMID: 38611057 PMCID: PMC11010994 DOI: 10.3390/cancers16071379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 03/29/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
MicroRNAs, short non-protein coding RNAs, are overexpressed in GCTs. Circulating levels of germ cell tumor (GCT)-associated miRNAs, such as miR-371a-3p, can be utilized as efficient and cost-effective alternatives in diagnosing and managing patients presenting with GCTs. This quality of miRNAs has demonstrated favorable performance characteristics as a reliable blood-based biomarker with high diagnostic accuracy compared to current serum tumor markers (STMs), including α-fetoprotein (AFP), beta human chorionic gonadotropin (β-hCG), and lactate dehydrogenase (LDH). The conventional STMs exhibit limited specificity and sensitivity. Potential clinical implications of miRNAs include impact on de-escalating or intensifying treatment, detecting recurrence at earlier stages, and lessening the necessity of cross-sectional imaging or invasive tissue biopsy for non-teratomatous GCTs. Here, we also highlight the outstanding issues that must be addressed prior to clinical implementation. Standards for measuring circulating miRNAs and determining ideal cutoff values are essential for integration into current clinical guidelines.
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Affiliation(s)
- Crystal L. Seales
- Morehouse School of Medicine, Atlanta, GA 30310, USA;
- Department of Urology, University of California San Diego, La Jolla, CA 92093, USA; (D.P.); (N.Y.); (K.P.); (K.Y.); (J.S.)
| | - Dhruv Puri
- Department of Urology, University of California San Diego, La Jolla, CA 92093, USA; (D.P.); (N.Y.); (K.P.); (K.Y.); (J.S.)
| | - Nuphat Yodkhunnatham
- Department of Urology, University of California San Diego, La Jolla, CA 92093, USA; (D.P.); (N.Y.); (K.P.); (K.Y.); (J.S.)
| | - Kshitij Pandit
- Department of Urology, University of California San Diego, La Jolla, CA 92093, USA; (D.P.); (N.Y.); (K.P.); (K.Y.); (J.S.)
| | - Kit Yuen
- Department of Urology, University of California San Diego, La Jolla, CA 92093, USA; (D.P.); (N.Y.); (K.P.); (K.Y.); (J.S.)
| | - Sarah Murray
- Department of Pathology, University of California San Diego, La Jolla, CA 92093, USA;
| | - Jane Smitham
- Department of Urology, University of California San Diego, La Jolla, CA 92093, USA; (D.P.); (N.Y.); (K.P.); (K.Y.); (J.S.)
| | - John T. Lafin
- Department of Urology, University Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Aditya Bagrodia
- Department of Urology, University of California San Diego, La Jolla, CA 92093, USA; (D.P.); (N.Y.); (K.P.); (K.Y.); (J.S.)
- Department of Urology, University Texas Southwestern Medical Center, Dallas, TX 75390, USA;
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Faraji A, Dehghani M, Khatibi A. Familial aspects of fear of cancer recurrence: current insights and knowledge gaps. Front Psychol 2023; 14:1279098. [PMID: 38034286 PMCID: PMC10684928 DOI: 10.3389/fpsyg.2023.1279098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Fear of cancer recurrence is fear or worry about cancer recurrence or progress. Fear of recurrence can impact patients' quality of life and wellbeing. Cancer survivors' families support them practically and emotionally, making them a vital supplement for official healthcare. Given the well-established important role of the family in dealing with cancer, we compiled the studies that examined the relationship between family-related factors and fear of cancer recurrence (FCR) among cancer survivors (CSs). One of the foremost studies in this field is the FCR model presented by Mellon and colleagues, which included concurrent family stressors and family-caregiver FCR as factors linked to survivor FCR. Our goal was to prepare the ground for a family-based model of FCR that is more comprehensive than the one proposed by Mellon et al. sixteen years ago. The studies included those with samples of adult cancer survivors from different regions of the world. Most of the studies we reviewed are cross-sectional studies. We categorized family-related factors associated with survivor FCR into partner-related factors, including subgroups of disclosure to partner, cognitions of partner, and partner's sources of support; parenthood-related factors, including having children and parenting stress; family-related factors, including living situation, family history of cancer, family's perception of the illness, and family characteristics; and social interactions including social support, disclosure, social constraints, and attitudes of others. This review sheds light on how significant others of cancer survivors can affect and be affected by cancer-related concerns of survivors and emphasizes the necessity of further investigation of family-related factors associated with FCR.
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Affiliation(s)
- Aida Faraji
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Mohsen Dehghani
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Ali Khatibi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
- Institute for Mental Health (IMH), School of Psychology, University of Birmingham, Birmingham, United Kingdom
- The Centre for Human Brain Health (CHBH), School of Psychology, University of Birmingham, Birmingham, United Kingdom
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Gelderblom ME, Jaspers V, Akkermans RP, Slangen B, Oei ALM, van Ginkel AA, Ngo H, IntHout J, Hermens RPMG, de Hullu JA, Piek JMJ. First step in implementation of opportunistic salpingectomy for prevention of ovarian cancer: Current care and its determinants. Acta Obstet Gynecol Scand 2023; 102:257-269. [PMID: 36661074 PMCID: PMC9951340 DOI: 10.1111/aogs.14507] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/20/2022] [Accepted: 12/25/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Opportunistic salpingectomy (OS) refers to additional removal of the fallopian tubes during abdominal surgery performed for another medical indication, as prevention for ovarian cancer. As OS has been inconsistently implemented, its clinical practice varies worldwide. To reduce this variation, insight is required into current clinical practice and its determinants. Therefore, the study aim was to determine the implementation of counseling and performance of OS between 2015 and 2018, and its patient, surgical, physician, and hospital characteristics. MATERIAL AND METHODS Retrospective study using electronic medical records from six different Dutch hospitals: two academic, two large teaching, and two non-teaching hospitals. Patients were considered eligible for OS if they underwent elective non-obstetric abdominal surgery for a gynecological indication from January 2015 through December 2018. Primary outcomes were uptake of counseling and performance of OS. Multilevel multivariable logistic regression analyses were conducted to identify characteristics associated with OS. RESULTS A total of 3214 patients underwent elective non-obstetric abdominal surgery for a gynecological indication and were eligible for OS. Counseling on OS increased significantly from 2.9% in 2015 to 29.4% in 2018. In this period, 440 patients were counseled on OS, of which 95.9% chose OS. Performance of OS increased significantly from 6.9% in 2015 to 44.5% in 2018. Counseling for and performance of OS were more likely in patients who had surgery by laparoscopic approach, were counseled by a gynecological resident, or had more than three contact moments before surgery. Additionally, OS was less likely in patients who had vaginal surgery. CONCLUSIONS Although the uptake of OS increased from 2015 to 2018, the majority of patients who were eligible for OS were not counseled and did not undergo OS. Its clinical practice varies on patient, surgery, and physician characteristics. Therefore, an implementation strategy tailored to associated determinants is recommended.
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Affiliation(s)
- Malou E. Gelderblom
- Department of Obstetrics and Gynecology, Radboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Veerle Jaspers
- Department of Obstetrics and Gynecology and Catharina Cancer InstituteCatharina HospitalEindhovenThe Netherlands
| | - Reinier P. Akkermans
- Radboud Institute for Health Sciences, Department of IQ health careRadboud University Medical CenterNijmegenThe Netherlands,Department of Primary and Community CareRadboud University Medical CenterNijmegenThe Netherlands
| | - Brigitte Slangen
- Department of Obstetrics and GynecologyMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Angele L. M. Oei
- Department of Obstetrics and GynecologyBernhoven HospitalUdenThe Netherlands
| | | | - Huy Ngo
- Department of Obstetrics and GynecologyElkerliek HospitalHelmondThe Netherlands
| | - Joanna IntHout
- Department for Health Evidence, Radboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Rosella P. M. G. Hermens
- Radboud Institute for Health Sciences, Department of IQ health careRadboud University Medical CenterNijmegenThe Netherlands
| | - Joanne A. de Hullu
- Department of Obstetrics and Gynecology, Radboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Jurgen M. J. Piek
- Department of Obstetrics and Gynecology and Catharina Cancer InstituteCatharina HospitalEindhovenThe Netherlands
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Psychological factors and the uptake of preventative measures in BRCA1/2 pathogenic variant carriers: results of a prospective cohort study. Hered Cancer Clin Pract 2022; 20:38. [PMID: 36536421 PMCID: PMC9761978 DOI: 10.1186/s13053-022-00244-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Women carrying BRCA1/2 pathogenic variants are exposed to elevated risks of developing breast cancer (BC) and are faced by a complex decision-making process on preventative measures, i.e., risk-reducing mastectomy (RRM), and intensified breast surveillance (IBS). In this prospective cohort study we investigated the effect of anxiety, personality factors and coping styles on the decision-making process on risk management options in women with pathogenic variants in BRCA1/2. METHODS Breast cancer unaffected and affected women with a pathogenic variant in the BRCA1 or BRCA2 gene were psychologically evaluated immediately before (T0), 6 to 8 weeks (T1) and 6 to 8 months (T2) after the disclosure of their genetic test results. Uptake of RRM and IBS was assessed at T2. Psychological data were gathered using questionnaires on risk perception, personality factors, coping styles, decisional conflict, depression and anxiety, including the Hospital Anxiety and Depression Scale (HADS). We performed tests on statistical significance and fitted a logistic regression based on significance level. RESULTS A total of 98 women were included in the analysis. Baseline anxiety levels in women opting for RRM were high but decreased over time, while they increased in women opting for intensified breast surveillance (IBS). Elevated levels of anxiety after genetic test result disclosure (T1) were associated with the decision to undergo RRM (p < 0.01; OR = 1.2, 95% CI = 1.05-1.42), while personal BC history and personality factors seemed to be less relevant. CONCLUSIONS Considering psychosocial factors influencing the decision-making process of women with pathogenic variants in BRCA1/2 may help improving their genetic and psychological counselling. When opting for IBS they may profit from additional medical and psychological counselling. TRIAL REGISTRATION Retrospectively registered at the German Clinical Trials Register under DRKS00027566 on January 13, 2022.
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Matsukawa M, Torishima M, Satoh C, Honda S, Kosugi S. Japanese women's reasons for accompaniment status to hereditary breast and ovarian cancer-focused genetic counseling. J Genet Couns 2021; 31:497-509. [PMID: 34661949 DOI: 10.1002/jgc4.1519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 11/08/2022]
Abstract
Genetic counselors routinely assess and understand clients' needs at the beginning of a session. Attending a genetic counseling session with or without companions is an objective sign that genetic counselors can easily notice. This study focused on clients' reasons for their accompaniment status for genetic counseling, which we categorize into attending with or without a companion(s). A questionnaire survey and interviews were conducted using snowball sampling, starting with the chief executive officer (CEO) of the Japanese hereditary breast and ovarian cancer (HBOC) support group. Of 32 participants, 19 continued with an in-depth interview after answering the questionnaire. Five themes were identified from the interview: (1) personal confidence, (2) decision-making style, (3) family members' habits and time availability, (4) considerations and conflicts with family members, and (5) healthcare provider's suggestion. Our data suggested that the clients expected their companion(s) to play certain roles. This indicates that the reasons of accompaniment status will be helpful for genetic counselors to understand both clients' and their families' motivations, personalities, habits, and psychosocial backgrounds. In a high-context culture such as that of Japan, accompaniment status may be a helpful sign to understand clients' true worries. In addition, some companions may be future clients in genetic counseling, due to the genetic nature of the disease. In conclusion, our study indicated that it is important for genetic counselors to record accompaniment status before the initial genetic counseling and to pay attention to its reasons at the beginning of the session, which may lead them to understand the client's psychosocial background to facilitate better client-centered genetic counseling.
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Affiliation(s)
- Manami Matsukawa
- Department of Medical Genetics and Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Clinical Genetics, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Masako Torishima
- Department of Genomic Medicine, Kyoto University School of Public Health, Kyoto, Japan.,Department of Clinical Genetics Units, Kyoto University Hospital, Kyoto, Japan
| | - Chika Satoh
- Department of Obstetrics and Gynecology, Kansai Medical University, Osaka, Japan
| | - Sayaka Honda
- Department of Clinical Genetics Units, Kyoto University Hospital, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Genetics and Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Clinical Genetics Units, Kyoto University Hospital, Kyoto, Japan
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Fear of cancer recurrence in patients undergoing germline genome sequencing. Support Care Cancer 2021; 29:7289-7297. [PMID: 34036439 DOI: 10.1007/s00520-021-06311-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Fear of cancer recurrence/occurrence (FCR/O) is prevalent and associated with poorer psychological outcomes but can also motivate individuals to pursue genomic information about cancer risk. Guided by Protection Motivation Theory, this study investigated FCR/O prevalence and associated factors among probands previously diagnosed with a cancer of likely heritable origin, and their relatives, who had agreed to have germline genome sequencing. METHODS Three hundred and forty-eight probands and 167 relatives completed the Concerns about Recurrence Questionnaire (adapted for occurrence for some relatives) within 1 month of agreeing to undertake genome sequencing. Linear regressions investigated demographic, disease, attitude and behavioral associations with FCR/O. RESULTS Probands demonstrated greater FCR compared to relatives. In probands, greater FCR was associated with being female, non-English speaking at home, less time since diagnosis, greater intention to change behavior if gene variant found, lower perceived ability to cope with results, higher perceived susceptibility to having a recurrence, and more negative attitudes towards uncertainty. For relatives with cancer, greater FCR was associated with being male, greater intention to change behavior if a gene variant found, and higher perceived susceptibility to recurrence. In relatives without cancer, greater FCO was associated with not having had genetic testing prior to this study, lower perceived ability to cope with results, and higher perceived susceptibility to developing cancer. CONCLUSION Current findings on FCR/O prevalence and associated demographic and attitudinal variables in those who pursue genomic risk information might be used to target interventions that can prevent adverse psychological outcomes in vulnerable patients.
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7
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Plamann K, McCarthy Veach P, LeRoy BS, MacFarlane IM, Petzel SV, Zierhut HA. Effects of monitoring versus blunting on the public's preferences for information in a hypothetical cancer diagnosis scenario. J Genet Couns 2020; 30:132-143. [PMID: 32583486 DOI: 10.1002/jgc4.1302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Monitoring and blunting are coping styles that characterize how people respond when faced with personally threatening situations. High monitors tend to pay more attention to, scan for, and amplify threatening cues; high blunters tend to avoid information and seek distractions when faced with a threatening event. This study sought to investigate possible differential effects of monitoring and blunting coping styles on information preferences in a hypothetical cancer diagnosis scenario in the adult general public of Minnesota. In a survey administered at a large public venue (2016 Minnesota State Fair), participants were asked to imagine they carried a gene mutation and were diagnosed with colon cancer. They indicated their information preference [modified Cassileth Information Styles Questionnaire (MCISQ)], completed two coping style measures [Miller Behavioral Style Scale (MBSS) and Threatening Medical Situations Inventory (TMSI)], rated their perceived severity of colon cancer (low, moderate, high), and answered demographic questions. Eight hundred fifty-five individuals provided usable data. Participants classified as monitors on the TMSI had significantly higher MCISQ scores (i.e., preferred more information) than those classified as blunters (p = .004). Those scoring high on monitoring and low on blunting on the MBSS preferred significantly more information than those scoring high on both monitoring and blunting (p = .04). Linear regression analysis revealed being a monitor (TMSI), scoring high on monitoring (MBSS), rating colon cancer as more severe, and having a higher education level were significant positive predictors of MCISQ scores. Results suggest individual differences in coping style, perceived severity, and education level affect desire for information. Genetic counselors should consider these patient characteristics (e.g., asking patients about their information preferences) and tailor their approaches accordingly.
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Affiliation(s)
- Katie Plamann
- Department of Clinical Genomics, Mayo Clinic Health System, Eau Claire, WI, USA
| | - Patricia McCarthy Veach
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
| | - Bonnie S LeRoy
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
| | - Ian M MacFarlane
- Department of Psychology, Elizabethtown College, Elizabethtown, PA, USA
| | - Sue V Petzel
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota Medical Center - Fairview, Minneapolis, MN, USA
| | - Heather A Zierhut
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
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Whitney CA, Dorfman CS, Shelby RA, Keefe FJ, Gandhi V, Somers TJ. Reminders of cancer risk and pain catastrophizing: relationships with cancer worry and perceived risk in women with a first-degree relative with breast cancer. Fam Cancer 2019; 18:9-18. [PMID: 29679190 DOI: 10.1007/s10689-018-0082-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
First-degree relatives of women with breast cancer may experience increased worry or perceived risk when faced with reminders of their own cancer risk. Worry and risk reminders may include physical symptoms (e.g., persistent breast pain) and caregiving experiences. Women who engage in pain catastrophizing may be particularly likely to experience increased distress when risk reminders are present. We examined the degree to which persistent breast pain and experience as a cancer caregiver were related to cancer worry and perceived risk in first-degree relatives of women with breast cancer (N = 85) and how catastrophic thoughts about breast pain could impact these relationships. There was a significant interaction between persistent breast pain and pain catastrophizing in predicting cancer worry (p = .03); among women who engaged in pain catastrophizing, cancer worry remained high even in the absence of breast pain. Pain catastrophizing also moderated the relationships between caregiving involvement and cancer worry (p = .003) and perceived risk (p = .03). As the degree of caregiving responsibility increased, cancer worry and perceived risk increased for women who engaged in pain catastrophizing; levels of cancer worry and perceived risk remained low and stable for women who did not engage in pain catastrophizing regardless of caregiving experience. The results suggest that first-degree relatives of breast cancer survivors who engage in pain catastrophizing may experience greater cancer worry and perceived risk and may benefit from interventions aimed at reducing catastrophic thoughts about pain.
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Affiliation(s)
- Colette A Whitney
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2200 W. Main Street, Suite 340, Durham, NC, 27705, USA
| | - Caroline S Dorfman
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2200 W. Main Street, Suite 340, Durham, NC, 27705, USA
| | - Rebecca A Shelby
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2200 W. Main Street, Suite 340, Durham, NC, 27705, USA
| | - Francis J Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2200 W. Main Street, Suite 340, Durham, NC, 27705, USA
| | - Vicky Gandhi
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2200 W. Main Street, Suite 340, Durham, NC, 27705, USA
| | - Tamara J Somers
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2200 W. Main Street, Suite 340, Durham, NC, 27705, USA.
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Catania AM, Sammut Scerri C, Catania GJ. Men's experience of their partners' breast cancer diagnosis, breast surgery and oncological treatment. J Clin Nurs 2019; 28:1899-1910. [PMID: 30667119 DOI: 10.1111/jocn.14800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 11/22/2018] [Accepted: 01/13/2019] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To investigate the experiences of male partners of female breast cancer patients who had undergone surgery and oncological treatment and who were still raising children. BACKGROUND Research on the psychological effects of breast cancer has focused primarily on the patients undergoing treatment, neglecting the effect of such a condition on their closest family members. This study addresses this gap by focusing on understanding the effects of this disease on male partners of these patients. DESIGN An interpretative phenomenological approach was used. METHODS Eight males whose female partners were diagnosed with primary breast cancer between the ages of 30 and 55 and who had young children still living at home at the time were interviewed by the first author of this article. Interviews were transcribed verbatim and analyzed using an interpretative phenomenological framework, in accordance with the guidelines in the COREQ checklist for qualitative studies. RESULTS Participants emphasized the difficulties they faced in trying to juggle work and family responsibilities while offering support to their partners, a task they felt ill-prepared for. At times, they felt excluded by their partners and worried about the impact of the disease on their children. A common fear was that of recurrence of the disease, and while some discussed the financial difficulties associated with treating the disease, others saw it as enhancing the potential for their personal and couple growth. CONCLUSIONS This study adds to the topic by uncovering the perspectives of male partners of breast cancer patients and the effects of their partner's condition on them and their families. RELEVANCE TO CLINICAL PRACTICE The results of this study can be used to inform policy when providing holistic care. They also highlight the importance of counselling and support interventions for partners of breast cancer patients.
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Sepulveda-Pacsi AL, Bakken S. Correlates of Dominicans' Identification of Cancer as a Worrisome Health Problem. J Immigr Minor Health 2018; 19:1227-1234. [PMID: 27766506 DOI: 10.1007/s10903-016-0509-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
There is a paucity of studies centering on the correlates of cancer worry among Hispanics from the Dominican Republic and the potential informatics strategies to address such worries. Data were analyzed using descriptive and correlational statistics, and logistic regression with the dependent variable of cancer worry. Independent variables for the regression were: age, gender, marital status, education, socioeconomic status, previous diagnosis of cancer, anxiety, depression, sleep disturbance, and chronic burden. Four variables significantly increased cancer worry: married marital status (OR = 1.19 [95% CI 1.01, 1.41]), younger age (OR = .992 [95% CI 0.987, 0.997]), less depression (OR = .96 [95% CI 0.94, 0.98]), and cancer diagnosis (OR = 2.12 [95% CI 1.24, 3.65]). New knowledge was generated on the contextual factors that influence these health concerns in a major Hispanic sub-group. Implications for practice, research and education are discussed.
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Affiliation(s)
- Alsacia L Sepulveda-Pacsi
- Lienhard School of Nursing, College of Health Professions, Pace University, 163 William Street, Room 513, New York, NY, 10038, USA.
| | - Suzanne Bakken
- Center for Evidence-Based Practice in the Underserved, Columbia University School of Nursing, 617 W. 168th Street, Rm 229, New York, NY, 10032, USA
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Karademas EC, Roussi P. Financial strain, dyadic coping, relationship satisfaction, and psychological distress: A dyadic mediation study in Greek couples. Stress Health 2017; 33:508-517. [PMID: 27885804 DOI: 10.1002/smi.2735] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/28/2016] [Accepted: 10/17/2016] [Indexed: 11/05/2022]
Abstract
Financial strain typically has a severe impact on a couple's functioning and the well-being of its members. In this study, we examined the indirect relation of financial strain to partners' relationship satisfaction and psychological distress, using dyadic coping as a mediator, in a sample of Greek couples. One hundred and eighteen couples participated in a cross-sectional study. Perceived material loss in the past and perceived threat of loss in the future were used as financial strain indices. The actor-partner interdependence mediation model was employed to test for the mediation hypotheses. According to the results, the complete mediation (i.e., only indirect) effects models showed an unsatisfactory fit to the data and were rejected. The partial mediation actor-partner interdependence mediation model revealed several statistically significant direct and indirect (actor and partner) effects of the financial strain indices. The results provide more support to the hypothesized mediated impact of financial strain on partners' relationship satisfaction than on psychological distress. The findings underline the importance of dyadic coping for couple's adaptation to financial strain. They also point to the need to examine responses to stress at a dyadic level.
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Affiliation(s)
| | - Pagona Roussi
- Department of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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12
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Morman NA, Byrne L, Collins C, Reynolds K, Bell JG. Breast Cancer Risk Assessment at the Time of Screening Mammography: Perceptions and Clinical Management Outcomes for Women at High Risk. J Genet Couns 2017; 26:776-784. [PMID: 28124179 DOI: 10.1007/s10897-016-0050-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 11/16/2016] [Indexed: 01/23/2023]
Abstract
The purpose of this study was to evaluate the utility of a breast cancer risk assessment (BCRA) at the time of screening mammogram. Women whose BCRA indicated a high risk for cancer received a letter with instructions for breast health care and genetic counseling if appropriate. After 6 months this group received surveys to evaluate their risk perception and their recall of, and compliance with, recommendations. We also explored the impact of other variables such as a recommendation for genetic counseling and physician communication with the women. After the BCRA, the majority of high risk women reported no change in their perceived risk of cancer. A woman's perceived risk of cancer after a BCRA was significantly associated with her recall of recommendations for breast health care, but not with compliance. A recommendation for genetic counseling was not significantly related to women's perceived risk of cancer after the BCRA. Ten percent of women who should have obtained genetic counseling actually completed an appointment. Women who discussed their BCRA results with their physicians were more compliant with a six month breast exam with a doctor (53% vs 17%, p = 0.018). Overall, women felt that the BCRA was helpful and did not cause undue stress or anxiety. Although the cohort's compliance with recommendations was suboptimal, physicians' interactions with their patients may have a positive influence on their compliance.
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Affiliation(s)
- Nichole A Morman
- OhioHealth Genetic Counseling Program, Bing Cancer Center, OhioHealth, Columbus, OH, 43214, USA.
| | - Lindsey Byrne
- OhioHealth Genetic Counseling Program, Bing Cancer Center, OhioHealth, Columbus, OH, 43214, USA
| | - Christy Collins
- OhioHealth Riverside Methodist Hospital, OhioHealth Research & Innovations Institute, Columbus, OH, USA
| | - Kelly Reynolds
- Department of Cancer Services, Bing Cancer Center, OhioHealth Riverside Methodist Hospital, Columbus, OH, USA
| | - Jeffrey G Bell
- Department of Cancer Services, Bing Cancer Center, OhioHealth Riverside Methodist Hospital, Columbus, OH, USA
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Sepulveda-Pacsi AL, Hiraldo G, Frederickson K. Cancer Worry Among Urban Dominican Women: A Qualitative Study. J Transcult Nurs 2016; 29:30-37. [PMID: 27758840 DOI: 10.1177/1043659616672062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Two thirds of respondents of a recent survey, primarily self-identified urban immigrant Dominican females, indicated that cancer was the health problem they worried about the most. PURPOSE The purpose of this qualitative study was to gain a greater understanding of the cancer worry experienced by Dominican women. DESIGN Giorgi's descriptive existential phenomenological framework and methodology guided the study. SETTING Washington Heights/Inwood community, New York City, New York. PARTICIPANTS Thirty-eight urban Dominican immigrant women were included in the study. METHOD Data were gathered using focus group interviews. All interviews were digitally recorded, transcribed verbatim from Spanish to English. The transcripts were analyzed using Giorgi's existential phenomenological data analysis process. FINDINGS Four essences unfolded: Cancer as Destiny, Faith, Influential Relationships, and Knowledge Acquisition. CONCLUSION New knowledge was generated on the contextual factors that influence cancer worry among a major Hispanic subgroup. Implications for nursing research and practice are described.
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Hashemi-Ghasemabadi M, Taleghani F, Kohan S, Yousefy A. Living under a cloud of threat: the experience of Iranian female caregivers with a first-degree relative with breast cancer. Psychooncology 2016; 26:625-631. [PMID: 27328629 DOI: 10.1002/pon.4198] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 06/09/2016] [Accepted: 06/18/2016] [Indexed: 11/12/2022]
Abstract
BACKGROUNDS Breast cancer is a global threat to all women, especially those having close relatives with breast cancer. Women who were caregivers to relatives with breast cancer are more vulnerable to stress caused by the perception of heightened risk of cancer. Because health measures and breast health are affected by cultural beliefs and social status, information about breast cancer should consider the cultural beliefs and values of the society. OBJECTIVES This study explored the experiences of Iranian women who were caregivers to relatives with breast cancer. METHODS In this qualitative content analysis study, 21 female caregivers of breast cancer patients were chosen by purposive sampling. Data were collected through interviews and analyzed using content analysis. RESULTS Data analysis developed 3 categories: perception of the concept of risk, changing views about femininity, and management of perceived threat. Perception of the risk of breast cancer increased in caregivers, and they tried to manage the perceived threat. They considered the breast to be an important part of women's lives, and breast cancer in relatives changed their view of femininity. CONCLUSION Understanding the experiences of breast cancer family caregivers in different cultures can help in planning, counseling, and effective intervention.
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Affiliation(s)
| | - Fariba Taleghani
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahnaz Kohan
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Yousefy
- Medical Education Research Center, Department of Medical Education, Isfahan University of Medical Sciences, Isfahan, Iran
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Ansa B, Yoo W, Whitehead M, Coughlin S, Smith S. Beliefs and Behaviors about Breast Cancer Recurrence Risk Reduction among African American Breast Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 13:ijerph13010046. [PMID: 26703650 PMCID: PMC4730437 DOI: 10.3390/ijerph13010046] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 11/17/2015] [Accepted: 11/24/2015] [Indexed: 01/07/2023]
Abstract
A growing body of evidence suggests that breast cancer recurrence risk is linked to lifestyle behaviors. This study examined correlations between breast cancer recurrence, risk reduction beliefs, and related behaviors among African American breast cancer survivors (AA BCSs). Study participants included 191 AA BCSs, mean age = 56.3 years, who completed a lifestyle assessment tool. Most respondents believed that being overweight (52.7%), lack of physical activity (48.7%), and a high fat diet (63.2%) are associated with breast cancer recurrence. Over 65% considered themselves overweight; one third (33.5%) agreed that losing weight could prevent recurrence, 33.0% disagreed, while the remaining 33.5% did not know; and nearly half (47.9%) believed that recurrence could be prevented by increasing physical activity. Almost 90% survivors with BMI < 25 Kg/M² reported no recurrence compared to 75.7% with BMI ≥ 25 Kg/M² (p = 0.06); nearly all of the women (99.2%) answered "yes" to seeking professional help to lose weight, 79.7% of which were recurrence-free (p = 0.05). These results provide information about AA BCSs' beliefs and behaviors protective against breast cancer recurrence. Additional research is warranted to determine the effectiveness of educational interventions for AA BCSs that promote consumption of a healthy diet and engaging in regular physical activity.
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Affiliation(s)
- Benjamin Ansa
- Institute of Public & Preventive Health, Georgia Regents University, CJ-2300 1120 15th Street Augusta, GA 30912, USA.
| | - Wonsuk Yoo
- Institute of Public & Preventive Health, Georgia Regents University, CJ-2300 1120 15th Street Augusta, GA 30912, USA.
- College of Dental Medicine, Georgia Regents University, Augusta, GA 30912, USA.
| | - Mary Whitehead
- SISTAAH Talk Breast Cancer Support Group, Miami, FL 33169, USA.
| | - Steven Coughlin
- Department of Community Health and Sustainability, Division of Public Health, University of Massachusetts, Lowell, MA 01854, USA.
| | - Selina Smith
- Institute of Public & Preventive Health, Georgia Regents University, CJ-2300 1120 15th Street Augusta, GA 30912, USA.
- Department of Family Medicine, Medical College of Georgia, Augusta, GA 30912, USA.
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16
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Adedoyin AC, Sherr ME, Adedoyin OO, Royse DD, Jackson MS, Adu-Boahene AB. The Characteristics of Effective Cancer Education Media Interventions among African Americans: A Systematic Review. ACTA ACUST UNITED AC 2015; 13:331-44. [PMID: 26673281 DOI: 10.1080/23761407.2015.1073514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Cancer incidence and mortality is a significant area of health disparity between African Americans and Caucasians. In the current article the authors used a systematic review design to examine the characteristics of different cancer media education intervention (CMEI) to increase access to cancer screenings for African Americans within a 30 year period (1980-2010). Ten computerized databases were searched using inclusion-exclusion criteria. Consequently, 179 potential studies were identified, and later reduced to 41 eligible studies through the inclusion-exclusion criteria. The eligible studies had a combined sample size of N = 12,764 respondents. The findings revealed that multi-media intervention strategies were the most common media intervention that led to increased cancer screenings among African Americans. The authors conclude with a call for social workers to be more involved in developing and following up with culturally appropriate media strategies that can increase the likelihood of early detection and successful treatment, thus reducing this important area of health disparity.
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Affiliation(s)
- A Christson Adedoyin
- a Department of Social Work, School of Public Health, College of Health Sciences, Samford University , Birmingham , Alabama , USA
| | - Michael E Sherr
- b Department of Social Work , University of Tennessee Chattanooga , Tennessee , USA
| | - Oreoluwa O Adedoyin
- c Cardio-Renal Physiology and Medicine, Division of Nephrology, University of Alabama at Birmingham , Alabama , USA
| | - David D Royse
- d College of Social Work, University of Kentucky , Lexington , Kentucky , USA
| | - Mary S Jackson
- e School of Social Work, College of Health and Human Performance, East Carolina University , Greenville , North Carolina , USA
| | - Akosua B Adu-Boahene
- f Department of Pediatrics , Women and Infants Hospital , Providence , Rhode Island , USA
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17
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Cancer Worry, Perceived Risk and Cancer Screening in First-Degree Relatives of Patients with Familial Gastric Cancer. J Genet Couns 2015; 25:520-8. [DOI: 10.1007/s10897-015-9903-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 10/15/2015] [Indexed: 12/19/2022]
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18
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Supportive Care Needs for Women With Gynecological Cancer and Their Relatives During the Prediagnostic Period. Cancer Nurs 2014; 37:457-67. [DOI: 10.1097/ncc.0000000000000117] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Roussi P, Miller SM. Monitoring style of coping with cancer related threats: a review of the literature. J Behav Med 2014; 37:931-54. [PMID: 24488543 DOI: 10.1007/s10865-014-9553-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 01/16/2014] [Indexed: 12/11/2022]
Abstract
Building on the Cognitive-Social Health Information-Processing model, this paper provides a theoretically guided review of monitoring (i.e., attend to and amplify) cancer-related threats. Specifically, the goals of the review are to examine whether individuals high on monitoring are characterized by specific cognitive, affective, and behavioral responses to cancer-related health threats than individuals low on monitoring and the implications of these cognitive-affective responses for patient-centered outcomes, including patient-physician communication, decision-making and the development of interventions to promote adherence and adjustment. A total of 74 reports were found, based on 63 studies, 13 of which were intervention studies. The results suggest that although individuals high on monitoring are more knowledgeable about health threats, they are less satisfied with the information provided. Further, they tend to be characterized by greater perceived risk, more negative beliefs, and greater value of health-related information and experience more negative affective outcomes. Finally, individuals high on monitoring tend to be more demanding of the health providers in terms of desire for more information and emotional support, are more assertive during decision-making discussions, and subsequently experience more decisional regret. Psychoeducational interventions improve outcomes when the level and type of information provided is consistent with the individual's monitoring style and the demands of the specific health threat. Implications for patient-centered outcomes, in terms of tailoring of interventions, patient-provider communication, and decision-making, are discussed.
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Affiliation(s)
- Pagona Roussi
- Department of Psychology, Aristotle University of Thessaloniki, Thessaloníki, Greece,
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20
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Eijzenga W, Hahn DEE, Aaronson NK, Kluijt I, Bleiker EMA. Specific psychosocial issues of individuals undergoing genetic counseling for cancer - a literature review. J Genet Couns 2013; 23:133-46. [PMID: 23996531 DOI: 10.1007/s10897-013-9649-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 08/12/2013] [Indexed: 01/02/2023]
Abstract
Approximately 25% of individuals undergoing genetic counseling for cancer experiences clinically relevant levels of distress, anxiety and/or depression. However, these general psychological outcomes that are used in many studies do not provide detailed information on the specific psychosocial problems experienced by counselees. The aim of this review was to investigate the specific psychosocial issues encountered by individuals undergoing genetic counseling for cancer, and to identify overarching themes across these issues. A literature search was performed, using four electronic databases (PubMed, PsychInfo, CINAHL and Embase). Papers published between January 2000 and January 2013 were selected using combinations, and related indexing terms of the keywords: 'genetic counseling', 'psychology' and 'cancer'. In total, 25 articles met our inclusion criteria. We identified the specific issues addressed by these papers, and used meta-ethnography to identify the following six overarching themes: coping with cancer risk, practical issues, family issues, children-related issues, living with cancer, and emotions. A large overlap in the specific issues and themes was found between these studies, suggesting that research on specific psychosocial problems within genetic counseling has reached a point of saturation. As a next step, efforts should be made to detect and monitor these problems of counselees at an early stage within the genetic counseling process.
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Affiliation(s)
- Willem Eijzenga
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands
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21
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Trivers KF, Patterson JR, Roland KB, Rodriguez JL. Issues of ovarian cancer survivors in the USA: a literature review. Support Care Cancer 2013; 21:2889-98. [PMID: 23846493 DOI: 10.1007/s00520-013-1893-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 06/25/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE As the number of ovarian cancer survivors increases, so does the need for appropriate intervention and care. A literature review was conducted to assess the issues affecting ovarian cancer survivors in the USA, including the needs of younger survivors. METHODS Articles on six topics (finances/employment, reproductive and sexual health, treatment effects, information needs, genomics, and end-of-life/palliative care) among ovarian cancer survivors were identified through comprehensive database searches. Abstracts for all citations were reviewed to determine relevancy. Data from relevant articles, defined as including a sample size of ≥ 20, published in English, involving human subjects in the USA, and published between 2000 and 2010, were abstracted. RESULTS Thirty-four articles were relevant. Common, but often unaddressed, treatment side effects included infertility and issues with sexual health. Survivors reported not receiving adequate information about their disease. Hereditary cancer can lead to concern for family members. End-of-life/palliative care was often not addressed by physicians. Most of the studies used a cross-sectional design and lacked control groups. Participants were primarily recruited from academic medical centers or clinical trials and tended to be White. Few studies specifically addressed young survivors; however, reproductive health issues are common. CONCLUSIONS Ovarian cancer has wide-ranging impacts. This review emphasizes the need for more research among ovarian cancer survivors, particularly related to finances, reproductive and sexual health, information, genomics, and end-of-life care. Issues specific to young survivors also deserve more attention. Direction for future research and clinical implications are discussed.
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Affiliation(s)
- Katrina F Trivers
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS F76, Atlanta, GA, 30341, USA,
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22
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den Heijer M, Gopie JP, Tibben A. Risk factors for psychological distress in women at risk for hereditary/familial breast cancer: a systematic review. BREAST CANCER MANAGEMENT 2013. [DOI: 10.2217/bmt.12.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Some women at risk for hereditary breast cancer are at increased risk of psychological distress. In order to correctly identify vulnerable women at an early stage for whom referral to a specialized psychologist or social worker may be considered, it is important that healthcare workers involved in the care of high-risk women have knowledge about risk factors that should be addressed during counseling. The aim of the current review is to investigate current knowledge on personal and social risk factors associated with psychological maladjustment in women at risk for hereditary breast cancer. The risk factors described in the current review may be used to develop appropriate interventions with respect to, for example, self-concept, risk appraisal, coping, family communication, social support and the partner relationship.
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Affiliation(s)
- Mariska den Heijer
- Department of Medical Psychology & Psychotherapy, Erasmus Medical Centre, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Jessica Premdee Gopie
- Centre of Human & Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Aad Tibben
- Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, The Netherlands
- Centre of Human & Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medical Psychology & Psychotherapy, Erasmus Medical Centre, Rotterdam, The Netherlands.
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23
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Felts M, Burke SC, Vail-Smith K, Whetstone LM. College Students' Knowledge, Attitudes and Perceptions of Risks Regarding Intentional Sun Exposure. AMERICAN JOURNAL OF HEALTH EDUCATION 2013. [DOI: 10.1080/19325037.2010.10599154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Michael Felts
- a Department of Health Education & Promotion , East Carolina University , Greenville , NC , 27858
| | - Sloane C. Burke
- b Department of Health Education & Promotion , East Carolina University , Greenville , NC , 27858
| | - Karen Vail-Smith
- c Department of Health Education & Promotion , East Carolina University, Greenville , NC , 27858
| | - Lauren MacKenzie Whetstone
- d Department of Family Medicine , Brody School of Medicine at East Carolina University, Research Division , Greenville , NC , 27858
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24
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Adéquation de la perception du risque de prédisposition génétique BRCA1/2 chez des femmes atteintes de cancer du sein (cas index) et facteurs associés. Bull Cancer 2012; 99:673-84. [DOI: 10.1684/bdc.2012.1590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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25
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Burris JL, Jacobsen PB, Loftus LS, Andrykowski MA. Breast cancer recurrence risk reduction beliefs in breast cancer survivors: prevalence and relation to behavior. Psychooncology 2012; 21:427-35. [PMID: 21312312 PMCID: PMC3116938 DOI: 10.1002/pon.1925] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 12/23/2010] [Accepted: 12/30/2010] [Indexed: 11/08/2022]
Abstract
OBJECTIVE There is a growing body of evidence suggesting breast cancer (BC) recurrence risk might be linked to behavioral factors. However, little is known about BC survivors' beliefs regarding the link between their behavior and recurrence risk. The objective of this study was to describe BC survivors' beliefs regarding performance of behaviors potentially associated with BC recurrence risk reduction, and to examine the link between these behaviors and BC recurrence risk reduction beliefs, worry, and risk perception. METHODS 200 female BC survivors (age, years: mean=57.7, standard deviation=9.2) completed a questionnaire assessing beliefs about the effectiveness of 14 potential BC recurrence risk reduction behaviors, their performance of these potential risk reduction behaviors, recurrence worry, and perception of personal lifetime BC recurrence risk. RESULTS The behaviors most frequently endorsed as potentially reducing BC recurrence risk included avoiding tobacco use (84%), exercising at least three times per week (74%), eating an average of five servings a day of fruits and vegetables (72%), and limiting food intake to maintain current weight or lose weight (70%). Multivariate logistic regression analyses predicting behavioral performance showed that beliefs were consistently associated with behavior while worry and risk perception were largely unrelated to behavior. CONCLUSIONS BC survivors' beliefs about the effectiveness of potential BC recurrence risk reduction behaviors are largely consistent with empirical findings and relate strongly to actual behavioral performance. Misconceptions about the effects of behavior to reduce BC recurrence risk are important targets for clinical and public health efforts.
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Affiliation(s)
- Jessica L. Burris
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY
- Department of Psychology, University of Kentucky College of Arts and Sciences, Lexington KY
| | - Paul B. Jacobsen
- Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
- Departments of Psychology and Interdisciplinary Oncology, University of South Florida, Tampa, FL
| | - Loretta S. Loftus
- Comprehensive Breast Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Michael A. Andrykowski
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY
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26
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Cancer perceptions: implications from the 2007 Health Information National Trends Survey. J Cancer Surviv 2012; 6:287-95. [DOI: 10.1007/s11764-012-0217-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 03/13/2012] [Indexed: 11/27/2022]
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27
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Leite-Pereira F, Medeiros R, Dinis-Ribeiro M. Overweight and obese patients do not seem to adequately recognize their own risk for colorectal cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2011; 26:767-773. [PMID: 21533584 DOI: 10.1007/s13187-011-0231-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED Being overweight is a risk factor for colorectal cancer; patients' adequate perception of their risk may lead to better involvement in management. The purpose of this study was to measure perception of risk for colorectal cancer in overweight and obese patients. A consecutive sample of overweight adult patients (n = 195) attending to nutritional counseling was submitted to clinical questionnaire addressing personal and family data, awareness about colorectal cancer risk factors, health status, and estimates of their own risk. Only 32% identified obesity among CCR risk factors. For 57% of participants, their own current BMI status did not confer any increased risk for CRC. Also, for half (46%) of the patients, their BMI status will not lead to an increased risk during lifetime. For 36%, an increased risk was accurately estimated as two or more. Accurate estimates tend to be made by older patients (p = 0.033), those with GI complaints (p = 0.040), or with familial history (p = 0.016). Even among patients attending to a nutritional consultation, only a third of patients seem to adequately consider their own overweight as a potential risk for colorectal cancer during lifetime. PRACTICE IMPLICATIONS health education programs concerning obesity must include colorectal cancer as a potential outcome for overweight patients.
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Affiliation(s)
- Fernanda Leite-Pereira
- CINTESIS/Biostatistics and Medical Informatics, Faculty of Medicine, University of Porto, Alameda Prof. Hernani Monteiro, 4200, Porto, Portugal
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Roussi P, Sherman KA, Miller SM, Hurley K, Daly MB, Godwin A, Buzaglo JS, Wen KY. Identification of cognitive profiles among women considering BRCA1/2 testing through the utilisation of cluster analytic techniques. Psychol Health 2011; 26:1327-43. [PMID: 21756124 PMCID: PMC3197930 DOI: 10.1080/08870446.2010.521938] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Based on the cognitive-social health information processing model, we identified cognitive profiles of women at risk for breast and ovarian cancer. Prior to genetic counselling, participants (N = 171) completed a study questionnaire concerning their cognitive and affective responses to being at genetic risk. Using cluster analysis, four cognitive profiles were generated: (a) high perceived risk/low coping; (b) low value of screening/high expectancy of cancer; (c) moderate perceived risk/moderate efficacy of prevention/low informativeness of test result; and (d) high efficacy of prevention/high coping. The majority of women in Clusters One, Two and Three had no personal history of cancer, whereas Cluster Four consisted almost entirely of women affected with cancer. Women in Cluster One had the highest number of affected relatives and experienced higher levels of distress than women in the other three clusters. These results highlight the need to consider the psychological profile of women undergoing genetic testing when designing counselling interventions and messages.
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Affiliation(s)
- Pagona Roussi
- Department of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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29
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Katapodi MC, Northouse L, Pierce P, Milliron KJ, Liu G, Merajver SD. Differences Between Women Who Pursued Genetic Testing for Hereditary Breast and Ovarian Cancer and Their At-Risk Relatives Who Did Not. Oncol Nurs Forum 2011; 38:572-81. [DOI: 10.1188/11.onf.572-581] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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30
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Vos J, Menko F, Jansen AM, van Asperen CJ, Stiggelbout AM, Tibben A. A whisper-game perspective on the family communication of DNA-test results: a retrospective study on the communication process of BRCA1/2-test results between proband and relatives. Fam Cancer 2011; 10:87-96. [PMID: 20852944 PMCID: PMC3036814 DOI: 10.1007/s10689-010-9385-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective of this paper is to study how DNA-test result information was communicated and perceived within families. A retrospective descriptive study in 13 probands with a BRCA1/2 unclassified variant, 7 with a pathogenic mutation, 5 with an uninformative result, and in 44, 14, and 12 of their 1st and 2nd degree relatives respectively. We examined differences and correlations between: (a) information actually communicated (b) probands' perception, (c) relatives' perception. The perception consisted of recollections and interpretations of both their own and their relatives' cancer-risks, and heredity-likelihood (i.e. likelihood that cancer is heritable in the family). Differences and low correlations suggested few similarities between the actually communicated information, the probands' and the relatives' perception. More specifically, probands recalled the communicated information differently compared with the actually communicated information (R = .40), and reinterpreted this information differently (R = .30). The relatives' perception was best correlated with the proband's interpretation (R = .08), but this perception differed significantly from their proband's perception. Finally, relatives reinterpreted the information they received from their proband differently (R = .25), and this interpretation was only slightly related with the original message communicated by the genetic-counsellor (R = .15). Unclassified-variants were most frequently misinterpreted by probands and relatives, and had the largest differences between probands' and relatives' perceptions. Like in a children's whisper-game, many errors occur in the transmission of DNA-test result information in families. More attention is required for how probands disseminate information to relatives. Genetic-counsellors may help by supporting the probands in communicating to relatives, e.g. by providing clear summary letters for relatives.
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Affiliation(s)
- Joël Vos
- Department of Clinical Genetics, Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands.
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31
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Tilburt JC, James KM, Sinicrope PS, Eton DT, Costello BA, Carey J, Lane MA, Ehlers SL, Erwin PJ, Nowakowski KE, Murad MH. Factors influencing cancer risk perception in high risk populations: a systematic review. Hered Cancer Clin Pract 2011; 9:2. [PMID: 21595959 PMCID: PMC3118965 DOI: 10.1186/1897-4287-9-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Accepted: 05/19/2011] [Indexed: 12/14/2022] Open
Abstract
Background Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history. Methods We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk. Results Of 1028 titles identified, 53 articles met our criteria. Most (92%) used an observational design and focused on women (70%) with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups) and few employed theory-driven analytic strategies to decipher interrelationships of factors. Conclusions Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although evolving, is still relatively undeveloped in several key topic areas including cancers other than breast and in specific populations. Future rigorous risk perception research using experimental designs and focused on cancers other than breast would advance the field.
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Affiliation(s)
- Jon C Tilburt
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
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Rubinstein WS, O'neill SM, Rothrock N, Starzyk EJ, Beaumont JL, Acheson LS, Wang C, Gramling R, Galliher JM, Ruffin MT. Components of family history associated with women's disease perceptions for cancer: a report from the Family Healthware™ Impact Trial. Genet Med 2011; 13:52-62. [PMID: 21150785 PMCID: PMC3927459 DOI: 10.1097/gim.0b013e3181fbe485] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To determine the specific components of family history and personal characteristics related to disease perceptions about breast, colon, and ovarian cancers. METHODS Baseline, cross-sectional data on 2,505 healthy women aged 35-65 years enrolled from 41 primary care practices in the cluster-randomized Family Healthware™ Impact Trial, assessed for detailed family history and perceived risk, perceived severity, worry, and perceived control over getting six common diseases including breast, colon, and ovarian cancers. RESULTS Participants provided family history information on 41,841 total relatives. We found evidence of underreporting of paternal family history and lower perceived breast cancer risk with cancer in the paternal versus maternal lineage. We observed cancer-specific perceived risks and worry for individual family history elements and also found novel "spillover" effects where a family history of one cancer was associated with altered disease perceptions of another. Having a mother with early-onset breast or ovarian cancer was strongly associated with perceived risk of breast cancer. Age, parenthood, and affected lineage were associated with disease perceptions and ran counter to empiric risks. CONCLUSIONS Understanding patients' formulation of risk for multiple diseases is important for public health initiatives that seek to inform risk appraisal, influence disease perceptions, or match preventive interventions to existing risk perceptions.
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Affiliation(s)
- Wendy S Rubinstein
- Center for Medical Genetics, NorthShore University HealthSystem, 1000 Central Street, Suite 620, Evanston, IL 60201, USA.
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Hamilton R, Williams JK, Skirton H, Bowers BJ. Living with genetic test results for hereditary breast and ovarian cancer. J Nurs Scholarsh 2009; 41:276-83. [PMID: 19723276 DOI: 10.1111/j.1547-5069.2009.01279.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine adaptation by nonsymptomatic individuals who knew the results of a genetic test for hereditary breast and ovarian cancer (HBOC) for at least 4 years. DESIGN Longitudinal grounded theory study. METHODS Follow-up interviews after a 3- to 4-year interval were conducted by telephone or e-mail with seven asymptomatic participants originally recruited for an earlier study of genetic testing experiences. A total of 14 interviews, 2 for each participant were conducted. Conceptual analysis on these 14 interviews focused on impact on daily life and health behavior decisions made in the intervening years. FINDINGS Participants described the impact of the result and adaptations made in relationships, sexuality, outlook, and plans for the future. Participants accepted recommended surveillance and preventative measures to maximize a healthy lifestyle and reported both the benefits of knowing their mutation status as well as challenges they had encountered since testing. CONCLUSIONS Adaptation to living with genetic test results indicating a disease-related mutation is an ongoing process of balancing the knowledge of risk with living a normal life. Over time, awareness of genetic risk does not appear to diminish. CLINICAL RELEVANCE Positive and negative long-term consequences of genetic testing for hereditary breast or ovarian cancer may influence many aspects of the personal lives and health care decisions of those tested.
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Affiliation(s)
- Rebekah Hamilton
- Department of Women, Children and Family Health Science, School of Nursing, University of Illinois at Chicago, IL 60612, USA.
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Abstract
Genetic testing for adult-onset diseases is now available. One such test is for the mutations present in the BRCA gene that result in a significantly higher risk for the development of breast cancer or ovarian cancer. Women who have one of these mutations face difficult choices in terms of increased surveillance or prophylactic surgeries. Examining experiences of women with BRCA mutations can serve as an exemplar for other populations at risk for genetically associated adult-onset diseases.
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Affiliation(s)
- Rebekah Hamilton
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA.
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Hamilton R, Williams JK, Bowers BJ, Calzone K. Life trajectories, genetic testing, and risk reduction decisions in 18-39 year old women at risk for hereditary breast and ovarian cancer. J Genet Couns 2009; 18:147-59. [PMID: 18979190 PMCID: PMC2834272 DOI: 10.1007/s10897-008-9200-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Accepted: 10/09/2008] [Indexed: 12/31/2022]
Abstract
This qualitative study identified four life trajectories that influenced the decision in young women to have genetic testing for mutations in BRCA1/2 and subsequent risk reduction decisions after receiving a positive mutation result. Fifty nine women between the ages of 18-39 years were interviewed in this grounded theory study, 44 of those tested were found to have a mutation in either BRCA1 or BRCA2. Of those with a mutation, 23 had no history of cancer and 21 had a breast cancer diagnosis. Analysis of the 44 participants tested found that risk reducing decisions were related to the life trajectories that preceded genetic testing. These life trajectories included: 1) Long-standing awareness of breast cancer in the family, 2) Loss of one's mother to breast cancer at a young age, 3) Expression of concern by a health care provider, and 4) Personal diagnosis of breast cancer. Understanding possible influences behind decision making for genetic testing and risk reduction in young women may assist health care providers in offering age appropriate guidance and support.
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Affiliation(s)
- Rebekah Hamilton
- Women, Children and Family Health Sciences, University of Illinois, Chicago, IL 60612, USA.
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Patenaude AF, Julian-Reynier C. Cancer genetic testing: current and emerging issues. Psychooncology 2009; 17:733-6. [PMID: 18688786 DOI: 10.1002/pon.1419] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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