1
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Dean M, Baker JT, Reblin M, Hintz EA, Vadaparampil ST, Haskins C, Quinn GP. Feasibility, acceptability, and outcomes of a pilot intervention facilitating communication about family building between patients with inherited cancer risk and their partners. PEC INNOVATION 2022; 1:100055. [PMID: 37213754 PMCID: PMC10194220 DOI: 10.1016/j.pecinn.2022.100055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/27/2022] [Accepted: 05/29/2022] [Indexed: 05/23/2023]
Abstract
Objective This study reports the feasibility, acceptability, and outcomes of a longitudinal, communication pilot intervention for patients with inherited cancer risk and their partners. Methods Couples were recruited through social media and snowball sampling. At Time 1 and 2, 15 couples completed a structured discussion task about family building concerns and decisions, followed by an online post-discussion questionnaire and dyadic interview to provide feedback about the experience. Interview data were analyzed to assess outcomes using applied thematic analysis. Results Participants reported the intervention created an opportunity for honest disclosure of family building goals and concerns. Participants also stated the structured nature of the discussion task was useful and did not cause additional stress. The intervention ultimately aided at-risk patients and their partners to realize their concordant concerns, discover/confront discordant concerns, and mutually agree upon next steps. Conclusions This pilot intervention is feasible and acceptable. Furthermore, it offers a framework to facilitate effective communication about family building between patients with inherited cancer risk and their partners. Innovation This intervention is the first conversational tool designed for at-risk patients and their partners.
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Affiliation(s)
- Marleah Dean
- Department of Communication, University of South Florida, Tampa, FL, USA
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Corresponding author at: Department of Communication, University of South Florida, 4202 E. Fowler Ave CIS 3068, Tampa, FL 33620, USA.
| | - Jonathan T. Baker
- Department of Communication, University of South Florida, Tampa, FL, USA
| | - Maija Reblin
- Department of Family Medicine, University of Vermont, VT, USA
| | | | | | - Carolyn Haskins
- Department of Genetic Counseling, Moffitt Cancer Center, Tampa, FL, USA
| | - Gwendolyn P. Quinn
- Department of OB-GYN, Grossman School of Medicine, New York University, NY, USA
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2
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Warner N, Groarke A, Gleeson C, Fahey P, Horgan R. Experiences of living with Lynch Syndrome: A reflexive thematic analysis. Eur J Oncol Nurs 2022; 58:102117. [DOI: 10.1016/j.ejon.2022.102117] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 02/03/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022]
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3
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Koch KE, Goffredo P, Hrabe JE, Gribovskaja-Rupp I, Snow AN, Bellizzi AM, Kapadia MR. Impact of routine mismatch repair screening on genetic counseling and surgical management in colorectal cancer patients. Am J Surg 2020; 222:408-412. [PMID: 33317812 DOI: 10.1016/j.amjsurg.2020.12.017] [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: 09/23/2020] [Revised: 12/02/2020] [Accepted: 12/06/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Mismatch repair (MMR) deficiency in colorectal cancer (CRC) should prompt consideration of genetic counseling (GC) as a Lynch syndrome (LS) diagnosis may have several implications for the patient and family. The study aims were to examine how routine MMR testing influences the rate of GC and surgical resection extent. METHODS A single-institution retrospective review was performed on CRC specimens (including colonoscopic biopsies) routinely screened for MMR deficiency from 2012 to 2018. MLH1-deficient cancers with mutated BRAF or MLH1-promoter hypermethylation were excluded. RESULTS MMR deficiency was identified in 295 of 1139 CRC specimens. After exclusions, 57 patients remained. Forty-two patients (74%) were identified preoperatively, and 35 (83%) were referred to GC: 16 were seen preoperatively, 9 postoperatively. Eight patients were diagnosed with Lynch syndrome (LS) preoperatively: 2 had no resection, 2 underwent segmental resection and 4 underwent extended resection. CONCLUSIONS Most MMR-deficient patients were identified and referred to GC preoperatively, though not all were seen. Of the preoperatively diagnosed LS patients, half underwent extended resection. Barriers to GC and decision-making around resection extent bears further study.
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Affiliation(s)
- Kelsey E Koch
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Paolo Goffredo
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Jennifer E Hrabe
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | | | - Anthony N Snow
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Andrew M Bellizzi
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Muneera R Kapadia
- Department of Surgery, University of North Carolina, Chapel Hill, NC, USA.
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4
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Omark J, Vilar E, You YN, Dunnington L, Noblin S, Stevens B, Mork M. Patients with unexplained mismatch repair deficiency are interested in updated genetic testing. Hered Cancer Clin Pract 2020; 18:19. [PMID: 32973963 PMCID: PMC7507605 DOI: 10.1186/s13053-020-00150-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 09/01/2020] [Indexed: 01/19/2023] Open
Abstract
Background Individuals who have colorectal or endometrial cancers displaying loss of immunohistochemical staining of one or more mismatch repair proteins without an identifiable causative germline pathogenic variant have unexplained mismatch repair deficiency (UMMRD). Comprehensive germline genetic testing for Lynch syndrome (LS) includes sequencing and deletion/duplication analysis of MLH1, MSH2, MSH6, and PMS2, deletion analysis of EPCAM, and MSH2 inversion analysis. Updated genetic testing to include elements of comprehensive LS testing not previously completed could further clarify LS status in individuals with UMMRD, allowing for tailored screening guidelines for affected individuals and their family members. However, patient understanding of the potential impact of updated genetic testing for LS is unclear. This study aimed to evaluate the interest in and perceived impact of updated genetic testing among individuals with UMMRD at a tertiary academic center. Methods A survey evaluating interest in and perceived impact of updated genetic testing was mailed to 98 potential participants. Electronic health record review was completed for all individuals meeting eligibility criteria. Thirty-one individuals responded to the survey. Results Results indicate this population is highly interested in updated genetic testing with the perceived impact being primarily for family members to have appropriate genetic testing and screening. Electronic health record review indicates that clinicians have an evolving understanding of causes of UMMRD, representing a potential change in assessment of cancer risk. Conclusions Updated risk assessment and genetic counseling with a discussion of the benefits and limitations of germline and somatic genetic testing, is essential as the understanding of UMMRD and genetic testing recommendations for this population evolve.
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Affiliation(s)
- Jessica Omark
- University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX USA.,Department of Pediatrics, University of Michigan Health System Michigan Medicine, Ann Arbor, MI USA
| | - Eduardo Vilar
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Y Nancy You
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Leslie Dunnington
- University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX USA.,Department of Pediatrics, University of Texas McGovern Medical School, Houston, TX USA
| | - Sarah Noblin
- University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX USA.,Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas McGovern Medical School, Houston, TX USA.,Natera, San Carlos, CA USA
| | - Blair Stevens
- University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX USA.,Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas McGovern Medical School, Houston, TX USA
| | - Maureen Mork
- University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX USA.,Department of Clinical Cancer Genetics, University of Texas MD Anderson Cancer Center, Houston, TX USA
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5
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Mazzella JM, Adham S, Frank M, Legrand A, Lahlou-Laforêt K, Jeunemaitre X. Communication of genetic information to at-risk relatives during the multidisciplinary monitoring of vascular Ehlers-Danlos syndrome in a French referral clinic. J Genet Couns 2020; 29:828-837. [PMID: 31903687 DOI: 10.1002/jgc4.1211] [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] [Received: 06/28/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 11/10/2022]
Abstract
Vascular Ehlers-Danlos syndrome (vEDS) is a rare inherited disorder leading to arterial, digestive, and uterine complications due to pathogenic COL3A1 variants. Identification of causal variants allows family screening, provided that relatives have previously been informed, according to a 2013 French Decree. The aims of our study were to assess the communication of genetic information to at-risk relatives, the impact of diagnosis disclosure and to highlight a possible link between the experience of vEDS patients and ability to communicate about genetic information. A total of n = 51 vEDS adult probands answered a questionnaire during a clinical visit. Communication to relatives was considered effective if the proband gave information to some or all first-degree relatives and considered easily achieved if it was disclosed to all relatives less than a month after the diagnosis and without difficulty. Personal and family vEDS experiences of probands were also assessed. Effective communication of information to relatives was remarkably high (98%). Siblings were the most frequently informed relatives (82%). Women informed their at-risk relatives of genetic family screening faster (p = .006) and easier (p = .004) than men. There was no difference in the disclosure of information to relatives before and after 2013 in our multidisciplinary clinic. Regarding the lived experience of vEDS patients, they felt anxious (78%) at diagnosis disclosure but also considered this diagnosis as an opportunity to start a medical follow-up (82%) putting an end to diagnosis delay. Our findings highlight for the first time that the ability to easily inform at-risk first-degree relatives is related to the relief felt during vEDS-positive diagnosis disclosure (p = .04). In order to improve the communication of genetic information to relatives, we believe that psychological support should systematically be part of the multidisciplinary monitoring, just as medical follow-up and genetic counseling.
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Affiliation(s)
- Jean-Michaël Mazzella
- Centre de Référence des Maladies Vasculaires Rares, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Salma Adham
- Centre de Référence des Maladies Vasculaires Rares, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.,Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Michael Frank
- Centre de Référence des Maladies Vasculaires Rares, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.,INSERM, U970, Paris centre de Recherche Cardiovasculaire - PARCC, Paris, France
| | - Anne Legrand
- Centre de Référence des Maladies Vasculaires Rares, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.,Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM, U970, Paris centre de Recherche Cardiovasculaire - PARCC, Paris, France
| | - Khadija Lahlou-Laforêt
- Centre de Référence des Maladies Vasculaires Rares, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.,Unité de Psychologie et Psychiatrie de Liaison et d'Urgence, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Xavier Jeunemaitre
- Centre de Référence des Maladies Vasculaires Rares, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.,Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM, U970, Paris centre de Recherche Cardiovasculaire - PARCC, Paris, France
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6
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Solomon I, Rybak C, Van Tongeren L, Kuzmich L, Blazer K, Nehoray B, Niell-Swiller M, Bray S, Bray TH, Hurley K, Weitzel JN, Slavin TP. Experience Gained from the Development and Execution of a Multidisciplinary Multi-syndrome Hereditary Colon Cancer Family Conference. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:1204-1212. [PMID: 30259397 PMCID: PMC6437007 DOI: 10.1007/s13187-018-1430-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Genetic healthcare professionals provide genetic cancer risk assessment and follow-up care for patients facing hereditary cancers. To meet the needs of those affected by hereditary colorectal cancer, City of Hope and the Hereditary Colon Cancer Foundation collaborated to develop a "Family Day" conference. We describe the development of our conference based upon the Hereditary Colon Cancer Foundation's "Family Day" program model, with refinements completed using the Participatory Action Research theoretical framework, which incorporated input from conference participants and researchers. Thirty-one participants attended the conference, representing patients with, or families, friends, and caregivers of those with, multiple colorectal cancer predisposition syndromes, including Lynch, familial adenomatous polyposis, and juvenile polyposis. Participants who completed the feedback surveys (n = 22) were highly satisfied with the presentation content, ranking the keynote lecture on family communication the highest of the conference events. Participants also provided feedback regarding how to improve future conferences. In conclusion, we share our experience and provide guidance for developing a successful hereditary colon cancer predisposition patient and family conference.
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Affiliation(s)
- Ilana Solomon
- City of Hope, Division of Clinical Cancer Genomics, Duarte, CA, USA
| | - Christina Rybak
- City of Hope, Division of Clinical Cancer Genomics, Duarte, CA, USA
| | | | - Lili Kuzmich
- City of Hope, Division of Clinical Cancer Genomics, Duarte, CA, USA
| | - Kathleen Blazer
- City of Hope, Division of Clinical Cancer Genomics, Duarte, CA, USA
| | - Bita Nehoray
- City of Hope, Division of Clinical Cancer Genomics, Duarte, CA, USA
| | | | - Shawnie Bray
- Hereditary Colon Cancer Foundation, Portland, OR, USA
| | - Travis H Bray
- Hereditary Colon Cancer Foundation, Portland, OR, USA
| | | | - Jeffrey N Weitzel
- City of Hope, Division of Clinical Cancer Genomics, Duarte, CA, USA.
| | - Thomas P Slavin
- City of Hope, Division of Clinical Cancer Genomics, Duarte, CA, USA.
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7
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Albiani JJ, McShane KE, Holter S, Semotiuk K, Aronson M, Cohen Z, Hart TL. The impact of health anxiety on perceptions of personal and children's health in parents with Lynch syndrome. J Genet Couns 2019; 28:495-506. [PMID: 30638287 DOI: 10.1002/jgc4.1043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 09/15/2018] [Accepted: 11/01/2018] [Indexed: 11/05/2022]
Abstract
This study examined the differences in perceptions of one's health and one's child's health between parents with Lynch syndrome (LS) characterized with high versus low health anxiety. Twenty-one parents completed semistructured telephone interviews about their perceptions of their own health and the health of their children. Qualitative content analysis using a template coding approach examined the differences between parents with high and low health anxiety. Findings revealed that the most prevalent difference emerged on perceptions of personal health, showing individuals with high health anxiety reported more extreme worries, were more hypervigilant about physical symptoms, experienced the emotional and psychological consequences of LS as more negative and severe, and engaged in more dysfunctional coping strategies than those with low health anxiety. Unexpectedly, with regards to perceptions of their children, parents in the high and low health anxiety groups exhibited similar worries. However, high health anxiety parents reported using dysfunctional coping about their children's health more frequently than those with low health anxiety. The findings suggest that health anxiety is of clinical significance for individuals with LS. Accurately identifying and treating health anxiety among this population may be one avenue to reduce the distress experienced by LS carriers.
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Affiliation(s)
- Jenna J Albiani
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Kelly E McShane
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Spring Holter
- Zane Cohen Centre for Digestive Diseases, Sinai Health System, Toronto, ON, Canada
| | - Kara Semotiuk
- Zane Cohen Centre for Digestive Diseases, Sinai Health System, Toronto, ON, Canada
| | - Melyssa Aronson
- Zane Cohen Centre for Digestive Diseases, Sinai Health System, Toronto, ON, Canada
| | - Zane Cohen
- Zane Cohen Centre for Digestive Diseases, Sinai Health System, Toronto, ON, Canada
| | - Tae L Hart
- Department of Psychology, Ryerson University, Toronto, ON, Canada.,Zane Cohen Centre for Digestive Diseases, Sinai Health System, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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8
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Esteban I, Vilaró M, Adrover E, Angulo A, Carrasco E, Gadea N, Sánchez A, Ocaña T, Llort G, Jover R, Cubiella J, Servitja S, Herráiz M, Cid L, Martínez S, Oruezábal-Moreno MJ, Garau I, Khorrami S, Herreros-de-Tejada A, Morales R, Cano JM, Serrano R, López-Ceballos MH, González-Santiago S, Juan-Fita MJ, Alonso-Cerezo C, Casas A, Graña B, Teulé A, Alba E, Antón A, Guillén-Ponce C, Sánchez-Heras AB, Alés-Martínez JE, Brunet J, Balaguer F, Balmaña J. Psychological impact of multigene cancer panel testing in patients with a clinical suspicion of hereditary cancer across Spain. Psychooncology 2018; 27:1530-1537. [PMID: 29498768 DOI: 10.1002/pon.4686] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 01/16/2018] [Accepted: 02/16/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Patients' psychological reactions to multigene cancer panel testing might differ compared with the single-gene testing reactions because of the complexity and uncertainty associated with the different possible results. Understanding patients' preferences and psychological impact of multigene panel testing is important to adapt the genetic counselling model. METHODS One hundred eighty-seven unrelated patients with clinical suspicion of hereditary cancer undergoing a 25-gene panel test completed questionnaires after pretest genetic counselling and at 1 week, 3 months, and 12 months after results to elicit their preferences regarding results disclosure and to measure their cancer worry and testing-specific distress and uncertainty. RESULTS A pathogenic variant was identified in 38 patients (34 high penetrance and 4 moderate penetrance variants), and 54 patients had at least one variant of uncertain significance. Overall, cancer panel testing was not associated with an increase in cancer worry after results disclosure (P value = .87). Twelve months after results, carriers of a moderate penetrance variant had higher distress and uncertainty scores compared with carriers of high penetrance variants. Cancer worry prior to genetic testing predicted genetic testing specific distress after results, especially at long term (P value <.001). Most of the patients reported the wish to know all genetic results. CONCLUSIONS Our results suggest that patients can psychologically cope with cancer panel testing, but distress and uncertainty observed in carriers of moderate penetrance cancer variants in this cohort warrant further research.
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Affiliation(s)
- I Esteban
- Hereditary Cancer Unit, Vall d'Hebron Institute of Oncology, Barcelona, Spain.,Genetics Department, Universidad Autònoma de Barcelona, Barcelona, Spain
| | - M Vilaró
- Oncology Data Science, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - E Adrover
- Medical Oncology Department, Hospital General de Albacete, Albacete, Spain
| | - A Angulo
- Myriad Genetics Spain, Alcobendas, Spain
| | - E Carrasco
- Hereditary Cancer Unit, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - N Gadea
- Medical Oncology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - A Sánchez
- Gastroenterology Department, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd)-Institut Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - T Ocaña
- Gastroenterology Department, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd)-Institut Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - G Llort
- Medical Oncology Department, Hospital Sabadell-Parc Taulí, Sabadell, Spain
| | - R Jover
- Gastroenterlogy Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - J Cubiella
- Gastroenterology Department, Complejo Hospitalario Universitario de Ourense, Instituto de Investigación Sanitaria Galicia Sur, CIBERehd, Ourense, Spain
| | - S Servitja
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - M Herráiz
- Gastroenterology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - L Cid
- Gastroenterology Department, Instituto Investigación Biomédica, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - S Martínez
- Medical Oncology Department, Hospital de Mataró, Madrid, Spain
| | | | - I Garau
- Medical Oncology Department, Hospital Son Llatzer, Palma de Mallorca, Spain
| | - S Khorrami
- Gastroenterology Department, Hospital Son Espases, Palma de Mallorca, Spain
| | - A Herreros-de-Tejada
- Gastroenterlogy Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - R Morales
- Medical Oncology Department, Hospital La Mancha Centro, Alcázar de San Juan, Spain
| | - J M Cano
- Medical Oncology Department, Hospital General de Ciudad Real, Ciudad Real, Spain
| | - R Serrano
- Medical Oncology Department, Hospital Reina Sofia de Córdoba, Córdoba, Spain
| | - M H López-Ceballos
- Medical Oncology Department, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - S González-Santiago
- Medical Oncology Department, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - M J Juan-Fita
- Medical Oncology Department, Instituto Valencia de Oncología, Valencia, Spain
| | | | - A Casas
- Medical Oncology Department, Hospital Virgen del Rocío de Sevilla, Seville, Spain
| | - B Graña
- Medical Oncology Department, Hospital Universitario de A Coruña, La Coruña, Spain
| | - A Teulé
- Hereditary Cancer Program, Catalan Institute of Oncology, L'Hospitalet, Spain
| | - E Alba
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - A Antón
- Medical Oncology Department, Hospital Miguel Servet de Zaragoza, Zaragoza, Spain
| | - C Guillén-Ponce
- Medical Oncology Department, Hospital Ramón y Cajal, Madrid, Spain
| | - A B Sánchez-Heras
- Medical Oncology Department, Hospital General Universitario de Elche, Elche, Spain
| | - J E Alés-Martínez
- Medical Oncology Department, Hospital de Nuestra Señora de Sonsoles, Ávila, Spain
| | - J Brunet
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBGI, Girona, Spain
| | - F Balaguer
- Gastroenterology Department, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd)-Institut Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - J Balmaña
- Hereditary Cancer Unit, Vall d'Hebron Institute of Oncology, Barcelona, Spain.,Genetics Department, Universidad Autònoma de Barcelona, Barcelona, Spain.,Medical Oncology Department, Vall d'Hebron Hospital, Barcelona, Spain
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9
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Peterson EB, Chou WYS, Gaysynsky A, Krakow M, Elrick A, Khoury MJ, Kaphingst KA. Communication of cancer-related genetic and genomic information: A landscape analysis of reviews. Transl Behav Med 2018; 8:59-70. [PMID: 29385592 PMCID: PMC6065548 DOI: 10.1093/tbm/ibx063] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Cancer-related genetic and genomic testing (CGT) is changing cancer care by personalizing care options, leading to an era of precision medicine. Advances in and increased use of CGT add complexity to clinical communication. This landscape analysis assessed published reviews of communication issues related to CGT and discusses implications for practice and behavioral research. A comprehensive electronic literature search was conducted of peer-reviewed literature reviews on studies related to CGT communication published between January 2010 and January 2017, resulting in a final sample of 24 reviews. Reviews were categorized, with overlaps, into four domains across the genetic testing communication continuum. Reviews on CGT-related knowledge, attitudes, and perceptions (n = 8) found that despite substantial public interest, their knowledge and awareness remains low. Providers also reported insufficient knowledge and overall caution, particularly regarding direct-to-consumer (DTC) genetic testing. Reviews of decision-making about CGT and test uptake (n = 8) identified individual, interpersonal, and systems-level barriers to uptake. Reviews of patient-provider CGT communication (n = 8) revealed limited communication and little empirical research on outcomes of communication or efforts at improving clinical and family communication. There were mixed findings in reviews (n = 15) on the psychological and behavioral impact of CGT, and DTC testing particularly had little effect on behaviors. Taken together, there is very little extant research in CGT in minority and underserved communities. In order for scientific advances in CGT to translate into equitable, patient-centered care, behavioral research, including health literacy and communication, plays critical roles.
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Affiliation(s)
- Emily B Peterson
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Wen-ying Sylvia Chou
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Anna Gaysynsky
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Melinda Krakow
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Ashley Elrick
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Muin J Khoury
- Office of Public Health Genomics, Centers for Disease Prevention and Control, Atlanta, GA, USA
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10
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Kagan SH, Maloney KW. Cancer Screening and Early Detection in Older People: Considerations for Nursing Practice. Semin Oncol Nurs 2017; 33:199-207. [PMID: 28343838 DOI: 10.1016/j.soncn.2017.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To synthesize relevant issues in cancer screening for older people for nursing practice. DATA SOURCES Published scientific literature, clinical literature, and published cancer screening guidelines from the United States and Canada. CONCLUSION Nurses are caring for increasing numbers of older patients and, with this demographic shift, face increasing demands to address cancer screening and detection in both primary and specialty practice. IMPLICATIONS FOR NURSING PRACTICE Ageism, self-stereotyping, cancer fear and fatalism, and cancer survivorship experiences influence cancer screening and generate the need for improved awareness of these issues to advance nursing practice.
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11
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Kohlmann W, Schiffman JD. Discussing and managing hematologic germ line variants. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2016; 2016:309-315. [PMID: 27913496 PMCID: PMC6142475 DOI: 10.1182/asheducation-2016.1.309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
With the introduction of genomic technologies, more hereditary cancer syndromes with hematologic malignancies are being described. Up to 10% of hematologic malignancies in children and adults may be the result of an underlying inherited genetic risk. Managing these patients with hereditary hematologic malignancies, including familial leukemia, remains a clinical challenge because there is little information about these relatively rare disorders. This article covers some of the issues related to the diagnosis and interpretation of variants associated with hereditary hematologic malignancies, including the importance of an accurate family history in interpreting genetic variants associated with disease. The challenges of screening other family members and offering the most appropriate early malignancy detection is also discussed. We now have a good opportunity to better define hereditary cancer syndromes with associated hematologic malignancies and contribute to clinically effective guidelines.
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Affiliation(s)
- Wendy Kohlmann
- Family Cancer Assessment Clinic, Huntsman Cancer Institute, and
| | - Joshua D. Schiffman
- Family Cancer Assessment Clinic, Huntsman Cancer Institute, and
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Utah, Salt Lake City, UT
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Discussing and managing hematologic germ line variants. Blood 2016; 128:2497-2503. [DOI: 10.1182/blood-2016-06-716704] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/09/2016] [Indexed: 12/22/2022] Open
Abstract
Abstract
With the introduction of genomic technologies, more hereditary cancer syndromes with hematologic malignancies are being described. Up to 10% of hematologic malignancies in children and adults may be the result of an underlying inherited genetic risk. Managing these patients with hereditary hematologic malignancies, including familial leukemia, remains a clinical challenge because there is little information about these relatively rare disorders. This article covers some of the issues related to the diagnosis and interpretation of variants associated with hereditary hematologic malignancies, including the importance of an accurate family history in interpreting genetic variants associated with disease. The challenges of screening other family members and offering the most appropriate early malignancy detection is also discussed. We now have a good opportunity to better define hereditary cancer syndromes with associated hematologic malignancies and contribute to clinically effective guidelines.
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13
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Educational and Psychosocial Support Needs in Lynch Syndrome: Implementation and Assessment of an Educational Workshop and Support Group. J Genet Couns 2016; 26:232-243. [PMID: 27734221 DOI: 10.1007/s10897-016-0015-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 09/01/2016] [Indexed: 12/20/2022]
Abstract
Few reports of educational and counseling support resources exist for Lynch syndrome (LS), a disorder requiring multi-organ cancer screening and specialized medical care throughout adult life. Here we describe the development and efficacy of two resources designed to address this need, the Memorial Sloan Kettering Cancer Center Clinical Genetics Service annual Lynch Syndrome Educational Workshop (LSEW), and a quarterly Lynch Syndrome Patient Advocacy Network (LSPAN) support group. The LSEW and LSPAN were implemented beginning in 2012. Participant survey data evaluating satisfaction, clarity, and unmet needs for each event were retrospectively analyzed and summarized using descriptive statistics. Annual LSEW attendance ranged from 53 to 75 total participants. LSEW year 1 participants indicated a need for a support group, and preferred in-person meetings at a frequency of every 3-6 months. For LSEW year 2-5 participants, >96 % reported satisfaction with the LSEW, and >82 % expressed interest in secure online support. Common themes for improvement included increased time for question and answer sessions and additional introductory genetics education. Responding LSPAN participants (n = 57 total survey responses in 11 meetings) found the meetings helpful (100 %), information clear (91 %), and presence of a genetic counselor useful (67 %). Desired discussion topics included coping with stress and anxiety, development of a support network, family communication about LS, genetic testing decisions, and bereavement. Following genetic counseling, a need exists for ongoing educational and emotional support in LS. Implementation of resources such as the LSEW and LSPAN is feasible and perceived as helpful by participants.
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