Exploring perceptions of genetic testing: an examination of perceived accuracy over time

The utility of Leventhal's model in the analysis of the psycho-behavioral implications of familial cancer - a literature review

INTRODUCTION

We aim to highlight the utility of this model in the analysis of the psycho-behavioral implications of family cancer, presenting the scientific literature that used Leventhal's model as the theoretical framework of approach.

MATERIAL AND METHODS

A systematic search was performed in six databases (EBSCO, ScienceDirect, PubMed Central, ProQuest, Scopus, and Web of Science) with empirical studies published between 2006 and 2015 in English with regard to the Common Sense Model of Self-Regulation (CSMR) and familial/hereditary cancer. The key words used were: illness representations, common sense model, self regulatory model, familial/hereditary/genetic cancer, genetic cancer counseling. The selection of studies followed the PRISMA-P guidelines (Moher et al., 2009; Shamseer et al., 2015), which suggest a three-stage procedure.

RESULTS

Individuals create their own cognitive and emotional representation of the disease when their health is threatened, being influenced by the presence of a family history of cancer, causing them to adopt or not a salutogenetic behavior. Disease representations, particularly the cognitive ones, can be predictors of responses to health threats that determine different health behaviors. Age, family history of cancer, and worrying about the disease are factors associated with undergoing screening. No consensus has been reached as to which factors act as predictors of compliance with cancer screening programs.

CONCLUSIONS

This model can generate interventions that are conceptually clear as well as useful in regulating the individuals' behaviors by reducing the risk of developing the disease and by managing as favorably as possible health and/or disease.

The LEGACY Girls Study: Growth and Development in the Context of Breast Cancer Family History

BACKGROUND

Although the timing of pubertal milestones has been associated with breast cancer risk, few studies of girls' development include girls at increased breast cancer risk due to their family history.

METHODS

The Lessons in Epidemiology and Genetics of Adult Cancer from Youth (LEGACY) Girls Study was initiated in 2011 in the USA and Canada to assess the relation between early life exposures and intermediate markers of breast cancer risk (e.g., pubertal development, breast tissue characteristics) and to investigate psychosocial well being and health behaviors in the context of family history. We describe the methods used to establish and follow a cohort of 1,040 girls ages 6-13 years at baseline, half with a breast cancer family history, and the collection of questionnaire data (family history, early life exposures, growth and development, psychosocial and behavioral), anthropometry, biospecimens, and breast tissue characteristics using optical spectroscopy.

RESULTS

During this initial 5-year phase of the study, follow-up visits are conducted every 6 months for repeated data and biospecimen collection. Participation in baseline components was high (98% for urine, 97.5% for blood or saliva, and 98% for anthropometry). At enrollment, 77% of girls were premenarcheal and 49% were at breast Tanner stage T1.

CONCLUSIONS

This study design allows thorough examination of events affecting girls' growth and development and how they differ across the spectrum of breast cancer risk. A better understanding of early life breast cancer risk factors will be essential to enhance prevention across the lifespan for those with and without a family history of the disease.

Breast Cancer Survivors' Knowledge of Hereditary Breast and Ovarian Cancer following Genetic Counseling: An Exploration of General and Survivor-Specific Knowledge Items

BACKGROUND

Previous studies found genetic counseling increased participants' knowledge about hereditary breast and ovarian cancer (HBOC). However, most explored knowledge gain in unaffected women and the scale most commonly used does not include items that may be more pertinent to breast cancer (BC) survivors.

AIMS

To explore whether genetic counseling impacts BC survivors' knowledge about HBOC and BC survivor-specific information.

METHODS

The National Center for Human Genome Research Knowledge Scale and 5 additional items specific to BC survivors were tested among BC survivors; before genetic counseling (time 1), 2-3 weeks after genetic counseling (time 2), and 6 months following genetic counseling (time 3).

RESULTS

A statistically significant change in knowledge over time was found. Post hoc analyses revealed statistically significant increases in knowledge between time 1 (median = 7.00) and time 2 (median = 10.00; p < 0.005), and between time 1 and time 3 (median = 9.00; p < 0.005).

CONCLUSION

Knowledge increased following genetic counseling, but the highest total average score at any time was <70% out of 100%. Additional analyses revealed items with low rates of correct response at all three time points, raising several concerns and the consideration of alternative approaches to measuring knowledge.

Contemplating genetic feedback regarding lung cancer susceptibility

BACKGROUND AND PURPOSE

We examined three theoretical models (self-enhancement theory, consistency theory, and a combined model) for understanding how expectations and test result favorability influence smokers' desire for a retest following hypothetical genetic test results.

METHOD

College smokers (N = 128) read a brochure describing a biomarker for lung cancer (the GSTM1 gene) then reported whether they thought they had the gene (indicating lower lung cancer risk) or were missing the gene (indicating higher lung cancer risk). Participants then reported whether they would get retested if they received favorable GSTM1 results versus unfavorable GSTM1 results.

RESULTS

Participants were most likely to want a retest, suggesting rejection of the results, if they expected favorable news yet received unfavorable news.

CONCLUSION

The findings supported the combined model such that smokers expressed greatest interest in a retest when they imagined genetic risk feedback that challenges both enhancement and consistency motives.

"Awakening to" a new meaning of being at-risk for arrhythmogenic right ventricular cardiomyopathy: a grounded theory study

Efforts of social scientists to understand how individuals living in a family at risk for a genetically linked condition make health care decisions, having brought to the forefront the contextual nature of risk perception. Using a grounded theory approach, this study examines the experiences of 29 individuals living in families at risk for arrhythmogenic right ventricular cardiomyopathy (ARVC). Attention is paid to how individuals (re)construct the meaning of being at risk in relation to the developing science of gene discovery. Findings highlight that individuals living in a family at risk for ARVC juxtapose existing scientific knowledge against experiential knowledge as they "awaken to" the fact that they or a family member are at risk. This process is pragmatic and fluid and contingent upon whether and how symptoms are aligned with the constructed image of the at-risk relative.