1
|
Wong EC, Kaplan CP, Barulich M, Melisko M. Assessing preferences for receiving supportive care resources among patients seen at a Breast Care Center. Breast Cancer Res Treat 2020; 183:381-389. [PMID: 32647938 DOI: 10.1007/s10549-020-05786-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/02/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Patients with breast cancer or at high risk for breast cancer have supportive care needs. Although cancer centers offer social, psychological, and other support to these patients, these services are not always utilized, and patients continue to report unmet supportive care needs. Reasons for non-utilization of these services have not been well documented. In this analysis, we examine patient reasons for service non-utilization and evaluate patients' interest in receiving information about and paying for other supportive care services. METHODS Study participants were contacted by email 7-14 months following appointments at the University of California, San Francisco (UCSF) Breast Care Center (BCC) and were invited to complete a 26-question survey about supportive care utilization at UCSF. RESULTS In total, 195 patients (45%) completed surveys. Of these, 68% had breast cancer. Among patients with breast cancer, fewer than half completed appointments with psychological services. Lack of self-perceived need was the primary reason patients did not pursue psychological services. Overall, 61% of participants were interested in learning more about psychological services, 27% in nutrition counseling, and 20% in exercise counseling. Participants were more interested in individual counseling than in group counseling but were less interested in paying for services. CONCLUSION Patients often feel that they do not need supportive services. Breast cancer patients are interested in learning more about psychological services, exercise counseling, and nutrition counseling. Although many cancer centers offer group coaching and counseling sessions on these topics, patients may be more willing to engage in individual counseling.
Collapse
Affiliation(s)
- Emily C Wong
- University of California San Francisco, San Francisco, California, USA.
| | - Celia P Kaplan
- University of California San Francisco, San Francisco, California, USA.,Multi-Ethnic Health Equity Research Center (MERC), University of California San Francisco, San Francisco, California, USA
| | - Mikela Barulich
- University of California San Francisco, San Francisco, California, USA
| | - Michelle Melisko
- University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
2
|
Bancroft EK, Saya S, Page EC, Myhill K, Thomas S, Pope J, Chamberlain A, Hart R, Glover W, Cook J, Rosario DJ, Helfand BT, Hutten Selkirk C, Davidson R, Longmuir M, Eccles DM, Gadea N, Brewer C, Barwell J, Salinas M, Greenhalgh L, Tischkowitz M, Henderson A, Evans DG, Buys SS, Eeles RA, Aaronson NK. Psychosocial impact of undergoing prostate cancer screening for men with BRCA1 or BRCA2 mutations. BJU Int 2019; 123:284-292. [PMID: 29802810 PMCID: PMC6378691 DOI: 10.1111/bju.14412] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To report the baseline results of a longitudinal psychosocial study that forms part of the IMPACT study, a multi-national investigation of targeted prostate cancer (PCa) screening among men with a known pathogenic germline mutation in the BRCA1 or BRCA2 genes. PARTICPANTS AND METHODS Men enrolled in the IMPACT study were invited to complete a questionnaire at collaborating sites prior to each annual screening visit. The questionnaire included sociodemographic characteristics and the following measures: the Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), 36-item short-form health survey (SF-36), Memorial Anxiety Scale for Prostate Cancer, Cancer Worry Scale-Revised, risk perception and knowledge. The results of the baseline questionnaire are presented. RESULTS A total of 432 men completed questionnaires: 98 and 160 had mutations in BRCA1 and BRCA2 genes, respectively, and 174 were controls (familial mutation negative). Participants' perception of PCa risk was influenced by genetic status. Knowledge levels were high and unrelated to genetic status. Mean scores for the HADS and SF-36 were within reported general population norms and mean IES scores were within normal range. IES mean intrusion and avoidance scores were significantly higher in BRCA1/BRCA2 carriers than in controls and were higher in men with increased PCa risk perception. At the multivariate level, risk perception contributed more significantly to variance in IES scores than genetic status. CONCLUSION This is the first study to report the psychosocial profile of men with BRCA1/BRCA2 mutations undergoing PCa screening. No clinically concerning levels of general or cancer-specific distress or poor quality of life were detected in the cohort as a whole. A small subset of participants reported higher levels of distress, suggesting the need for healthcare professionals offering PCa screening to identify these risk factors and offer additional information and support to men seeking PCa screening.
Collapse
Affiliation(s)
- Elizabeth K. Bancroft
- Oncogenetics TeamRoyal Marsden NHS Foundation TrustLondonUK
- Oncogenetics TeamInstitute of Cancer ResearchLondonUK
| | - Sibel Saya
- Oncogenetics TeamRoyal Marsden NHS Foundation TrustLondonUK
- Oncogenetics TeamInstitute of Cancer ResearchLondonUK
| | - Elizabeth C. Page
- Oncogenetics TeamRoyal Marsden NHS Foundation TrustLondonUK
- Oncogenetics TeamInstitute of Cancer ResearchLondonUK
| | - Kathryn Myhill
- Oncogenetics TeamRoyal Marsden NHS Foundation TrustLondonUK
- Oncogenetics TeamInstitute of Cancer ResearchLondonUK
| | - Sarah Thomas
- Oncogenetics TeamRoyal Marsden NHS Foundation TrustLondonUK
- Oncogenetics TeamInstitute of Cancer ResearchLondonUK
| | - Jennifer Pope
- Oncogenetics TeamRoyal Marsden NHS Foundation TrustLondonUK
- Oncogenetics TeamInstitute of Cancer ResearchLondonUK
| | - Anthony Chamberlain
- Oncogenetics TeamRoyal Marsden NHS Foundation TrustLondonUK
- Oncogenetics TeamInstitute of Cancer ResearchLondonUK
| | - Rachel Hart
- Clinical Genetics UnitBirmingham Women's HospitalBirminghamUK
| | - Wayne Glover
- Clinical Genetics UnitBirmingham Women's HospitalBirminghamUK
| | - Jackie Cook
- Sheffield Clinical Genetics ServiceSheffield Children's HospitalSheffieldUK
| | | | - Brian T. Helfand
- John and Carol Walter Center for Urological HealthNorthShore University HealthSystemEvanstonILUSA
| | - Christina Hutten Selkirk
- John and Carol Walter Center for Urological HealthNorthShore University HealthSystemEvanstonILUSA
| | - Rosemarie Davidson
- Clinical Genetics DepartmentQueen Elizabeth University HospitalGlasgowUK
| | - Mark Longmuir
- Clinical Genetics DepartmentQueen Elizabeth University HospitalGlasgowUK
| | - Diana M. Eccles
- Wessex Clinical Genetics ServicePrincess Anne HospitalSouthamptonUK
- Faculty of MedicineUniversity of SouthamptonUniversity Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Neus Gadea
- High Risk and Cancer Prevention ClinicVall d'Hebron University HospitalBarcelonaSpain
| | - Carole Brewer
- Clinical Genetics DepartmentRoyal Devon and Exeter HospitalExeterUK
| | - Julian Barwell
- Department of GeneticsUniversity of LeicesterLeicesterUK
- Clinical GeneticsUniversity Hospitals LeicesterLeicesterUK
| | - Monica Salinas
- Hereditary Cancer ProgrammeCatalan Institute of Oncology (ICO‐IDIBELL, CIBERONC)L'Hospitalet de LlobregatBarcelonaSpain
| | - Lynn Greenhalgh
- Cheshire and Mersey Clinical Genetics ServiceLiverpool Women's HospitalLiverpoolUK
| | - Marc Tischkowitz
- Academic Department of Medical GeneticsUniversity of CambridgeCambridgeUK
| | - Alex Henderson
- Northern Genetics ServiceNewcastle upon Tyne HospitalsNewcastleUK
| | - David Gareth Evans
- Manchester Centre for Genomic MedicineCentral Manchester University Hospitals NHS Foundation TrustManchesterUK
| | - Saundra S. Buys
- Huntsman Cancer InstituteUniversity of Utah HealthSalt Lake CityUTUSA
| | | | | | - Rosalind A. Eeles
- Oncogenetics TeamRoyal Marsden NHS Foundation TrustLondonUK
- Oncogenetics TeamInstitute of Cancer ResearchLondonUK
| | - Neil K. Aaronson
- Division of Psychosocial Research and EpidemiologyNetherlands Cancer InstituteAmsterdamThe Netherlands
| |
Collapse
|
3
|
Adejumo P, Aniagwu T, Oluwatosin A, Fagbenle O, Ajayi O, Ogungbade D, Oluwamotemi A, Olatoye-Wahab F, Oni A, Olajide O, Adedokun B, Ogundiran T, Olopade O. Knowledge of Genetic Counseling Among Patients With Breast Cancer and Their Relatives at a Nigerian Teaching Hospital. J Glob Oncol 2018; 4:1-8. [PMID: 30084716 PMCID: PMC6223535 DOI: 10.1200/jgo.17.00158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Breast cancer prevalence continues to increase globally, and a significant proportion of the disease has been linked to genetic susceptibility. As we enter the era of precision medicine, genetics knowledge and skills are increasingly essential for achieving optimal cancer prevention and care. However, in Nigeria, patients with breast cancer and their relatives are less knowledgeable about genetic susceptibility to chronic diseases. This pilot study collected qualitative data during in-depth interviews with 21 participants. Of these, 19 participants were patients with breast cancer and two were relatives of patients with breast cancer. Participants were asked questions regarding their knowledge of breast cancer, views on heredity and breast cancer, and views on genetic counseling. Participants' family histories were used as a basis with which to assess their hereditary risk of breast cancer. Participant responses were audio recorded and transcribed manually. The study evaluated patients' and relatives' knowledge of genetic counseling and the use of family history for the assessment of familial risk of breast cancer. This will serve as a guide to the processes of establishing a cancer risk assessment clinic.
Collapse
Affiliation(s)
- Prisca Adejumo
- Prisca Adejumo, Abimbola Oluwatosin, Babatunde Adedokun, College of Medicine, University of Ibadan, Ibadan; Toyin Aniagwu, Omolara Fagbenle, Olubunmi Ajayi, Dasola Ogungbade, Adeyoola Oluwamotemi, Funmilola Olatoye-Wahab, Abiodun Oni, Oluyemi Olajide, and Temidayo Ogundiran, University College Hospital, Oyo, Nigeria; and Olufunmilayo Olopade, The University of Chicago, Chicago, IL
| | - Toyin Aniagwu
- Prisca Adejumo, Abimbola Oluwatosin, Babatunde Adedokun, College of Medicine, University of Ibadan, Ibadan; Toyin Aniagwu, Omolara Fagbenle, Olubunmi Ajayi, Dasola Ogungbade, Adeyoola Oluwamotemi, Funmilola Olatoye-Wahab, Abiodun Oni, Oluyemi Olajide, and Temidayo Ogundiran, University College Hospital, Oyo, Nigeria; and Olufunmilayo Olopade, The University of Chicago, Chicago, IL
| | - Abimbola Oluwatosin
- Prisca Adejumo, Abimbola Oluwatosin, Babatunde Adedokun, College of Medicine, University of Ibadan, Ibadan; Toyin Aniagwu, Omolara Fagbenle, Olubunmi Ajayi, Dasola Ogungbade, Adeyoola Oluwamotemi, Funmilola Olatoye-Wahab, Abiodun Oni, Oluyemi Olajide, and Temidayo Ogundiran, University College Hospital, Oyo, Nigeria; and Olufunmilayo Olopade, The University of Chicago, Chicago, IL
| | - Omolara Fagbenle
- Prisca Adejumo, Abimbola Oluwatosin, Babatunde Adedokun, College of Medicine, University of Ibadan, Ibadan; Toyin Aniagwu, Omolara Fagbenle, Olubunmi Ajayi, Dasola Ogungbade, Adeyoola Oluwamotemi, Funmilola Olatoye-Wahab, Abiodun Oni, Oluyemi Olajide, and Temidayo Ogundiran, University College Hospital, Oyo, Nigeria; and Olufunmilayo Olopade, The University of Chicago, Chicago, IL
| | - Olubunmi Ajayi
- Prisca Adejumo, Abimbola Oluwatosin, Babatunde Adedokun, College of Medicine, University of Ibadan, Ibadan; Toyin Aniagwu, Omolara Fagbenle, Olubunmi Ajayi, Dasola Ogungbade, Adeyoola Oluwamotemi, Funmilola Olatoye-Wahab, Abiodun Oni, Oluyemi Olajide, and Temidayo Ogundiran, University College Hospital, Oyo, Nigeria; and Olufunmilayo Olopade, The University of Chicago, Chicago, IL
| | - Dasola Ogungbade
- Prisca Adejumo, Abimbola Oluwatosin, Babatunde Adedokun, College of Medicine, University of Ibadan, Ibadan; Toyin Aniagwu, Omolara Fagbenle, Olubunmi Ajayi, Dasola Ogungbade, Adeyoola Oluwamotemi, Funmilola Olatoye-Wahab, Abiodun Oni, Oluyemi Olajide, and Temidayo Ogundiran, University College Hospital, Oyo, Nigeria; and Olufunmilayo Olopade, The University of Chicago, Chicago, IL
| | - Adeyoola Oluwamotemi
- Prisca Adejumo, Abimbola Oluwatosin, Babatunde Adedokun, College of Medicine, University of Ibadan, Ibadan; Toyin Aniagwu, Omolara Fagbenle, Olubunmi Ajayi, Dasola Ogungbade, Adeyoola Oluwamotemi, Funmilola Olatoye-Wahab, Abiodun Oni, Oluyemi Olajide, and Temidayo Ogundiran, University College Hospital, Oyo, Nigeria; and Olufunmilayo Olopade, The University of Chicago, Chicago, IL
| | - Funmilola Olatoye-Wahab
- Prisca Adejumo, Abimbola Oluwatosin, Babatunde Adedokun, College of Medicine, University of Ibadan, Ibadan; Toyin Aniagwu, Omolara Fagbenle, Olubunmi Ajayi, Dasola Ogungbade, Adeyoola Oluwamotemi, Funmilola Olatoye-Wahab, Abiodun Oni, Oluyemi Olajide, and Temidayo Ogundiran, University College Hospital, Oyo, Nigeria; and Olufunmilayo Olopade, The University of Chicago, Chicago, IL
| | - Abiodun Oni
- Prisca Adejumo, Abimbola Oluwatosin, Babatunde Adedokun, College of Medicine, University of Ibadan, Ibadan; Toyin Aniagwu, Omolara Fagbenle, Olubunmi Ajayi, Dasola Ogungbade, Adeyoola Oluwamotemi, Funmilola Olatoye-Wahab, Abiodun Oni, Oluyemi Olajide, and Temidayo Ogundiran, University College Hospital, Oyo, Nigeria; and Olufunmilayo Olopade, The University of Chicago, Chicago, IL
| | - Oluyemi Olajide
- Prisca Adejumo, Abimbola Oluwatosin, Babatunde Adedokun, College of Medicine, University of Ibadan, Ibadan; Toyin Aniagwu, Omolara Fagbenle, Olubunmi Ajayi, Dasola Ogungbade, Adeyoola Oluwamotemi, Funmilola Olatoye-Wahab, Abiodun Oni, Oluyemi Olajide, and Temidayo Ogundiran, University College Hospital, Oyo, Nigeria; and Olufunmilayo Olopade, The University of Chicago, Chicago, IL
| | - Babatunde Adedokun
- Prisca Adejumo, Abimbola Oluwatosin, Babatunde Adedokun, College of Medicine, University of Ibadan, Ibadan; Toyin Aniagwu, Omolara Fagbenle, Olubunmi Ajayi, Dasola Ogungbade, Adeyoola Oluwamotemi, Funmilola Olatoye-Wahab, Abiodun Oni, Oluyemi Olajide, and Temidayo Ogundiran, University College Hospital, Oyo, Nigeria; and Olufunmilayo Olopade, The University of Chicago, Chicago, IL
| | - Temidayo Ogundiran
- Prisca Adejumo, Abimbola Oluwatosin, Babatunde Adedokun, College of Medicine, University of Ibadan, Ibadan; Toyin Aniagwu, Omolara Fagbenle, Olubunmi Ajayi, Dasola Ogungbade, Adeyoola Oluwamotemi, Funmilola Olatoye-Wahab, Abiodun Oni, Oluyemi Olajide, and Temidayo Ogundiran, University College Hospital, Oyo, Nigeria; and Olufunmilayo Olopade, The University of Chicago, Chicago, IL
| | - Olufunmilayo Olopade
- Prisca Adejumo, Abimbola Oluwatosin, Babatunde Adedokun, College of Medicine, University of Ibadan, Ibadan; Toyin Aniagwu, Omolara Fagbenle, Olubunmi Ajayi, Dasola Ogungbade, Adeyoola Oluwamotemi, Funmilola Olatoye-Wahab, Abiodun Oni, Oluyemi Olajide, and Temidayo Ogundiran, University College Hospital, Oyo, Nigeria; and Olufunmilayo Olopade, The University of Chicago, Chicago, IL
| |
Collapse
|
4
|
Eid M, Nahon-Serfaty I. Ethics, Risk, and Media Intervention. Oncology 2017. [DOI: 10.4018/978-1-5225-0549-5.ch023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Breast cancer incidence and mortality rates are of concern among Latin American women, mainly due to the growing prevalence of this disease and the lack of compliance to proper breast cancer screening and treatment. Focusing on Venezuelan women and the challenges and barriers that interact with their health communication, this paper looks into issues surrounding women's breast cancer, such as the challenges and barriers to breast cancer care, the relevant ethics and responsibilities, the right to health, breast cancer risk perception and risk communication, and the media interventions that affect Venezuelan women's perceptions and actions pertaining to this disease. In particular, it describes an action-oriented research project in Venezuela that was conducted over a four-year period of collaborative work among researchers, practitioners, NGOs, patients, journalists, and policymakers. The outcomes include positive indications on more effective interactions between physicians and patients, increasing satisfactions about issues of ethical treatment in providing healthcare services, more sufficient and responsible media coverage of breast cancer healthcare services and information, a widely supported declaration for a national response against breast cancer in Venezuela, and the creation of a code of ethics for the Venezuelan NGO that led the expansion of networking in support of women's breast cancer healthcare.
Collapse
|
5
|
Eid M, Nahon-Serfaty I. Ethics, Risk, and Media Intervention: Women's Breast Cancer in Venezuela. INTERNATIONAL JOURNAL OF RISK AND CONTINGENCY MANAGEMENT 2015; 4:49-69. [PMID: 27867750 DOI: 10.4018/ijrcm.2015070104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Breast cancer incidence and mortality rates are of concern among Latin American women, mainly due to the growing prevalence of this disease and the lack of compliance to proper breast cancer screening and treatment. Focusing on Venezuelan women and the challenges and barriers that interact with their health communication, this paper looks into issues surrounding women's breast cancer, such as the challenges and barriers to breast cancer care, the relevant ethics and responsibilities, the right to health, breast cancer risk perception and risk communication, and the media interventions that affect Venezuelan women's perceptions and actions pertaining to this disease. In particular, it describes an action-oriented research project in Venezuela that was conducted over a four-year period of collaborative work among researchers, practitioners, NGOs, patients, journalists, and policymakers. The outcomes include positive indications on more effective interactions between physicians and patients, increasing satisfactions about issues of ethical treatment in providing healthcare services, more sufficient and responsible media coverage of breast cancer healthcare services and information, a widely supported declaration for a national response against breast cancer in Venezuela, and the creation of a code of ethics for the Venezuelan NGO that led the expansion of networking in support of women's breast cancer healthcare.
Collapse
Affiliation(s)
- Mahmoud Eid
- Department of Communication, University of Ottawa, Ottawa, Ontario, Canada
| | | |
Collapse
|
6
|
|
7
|
Van Riel E, Wárlám-Rodenhuis CC, Verhoef S, Rutgers EJTH, Ausems MGEM. BRCA testing of breast cancer patients: medical specialists' referral patterns, knowledge and attitudes to genetic testing. Eur J Cancer Care (Engl) 2009; 19:369-76. [PMID: 19659662 DOI: 10.1111/j.1365-2354.2008.01065.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
This study explores knowledge about hereditary breast cancer, attitudes about BRCA testing and referral pattern to a family cancer clinic among medical specialists. A total of 92 questionnaires were completed by surgeons (38), medical oncologists (29), radiation oncologists (13) and radiologists (12). The response rate was 51%. A substantial (11-56%) proportion of medical specialists do not refer patients who meet current criteria for BRCA testing. Although questions on inheritance were less well answered, overall knowledge was good. They had a positive attitude, but were concerned about the distress DNA testing might cause to family members. The majority (75%) stated that the best time for referral is after adjuvant therapy or during follow-up, but another important determinant was the patient's wish or need (12%). Further studies are needed to gain insight into the actual referral process, while ongoing training of medical specialists about genetic aspects of breast cancer is also necessary.
Collapse
Affiliation(s)
- E Van Riel
- Department of Medical Genetics, University Medical Centre Utrecht, Utrecht, the Netherlands.
| | | | | | | | | |
Collapse
|
8
|
Conflict between values and technology: perceptions of preimplantation genetic diagnosis among women at increased risk for hereditary breast and ovarian cancer. Fam Cancer 2009; 8:441-9. [PMID: 19554475 DOI: 10.1007/s10689-009-9263-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2008] [Accepted: 06/09/2009] [Indexed: 10/20/2022]
Abstract
Members of families affected by hereditary cancer are often concerned about passing on risk to offspring. Preimplantation genetic diagnosis is a procedure performed to identify embryos that inherit mutations placing them at risk for hereditary conditions. Little is known about attitudes toward the use of this technology among individuals at risk for hereditary breast and ovarian cancer. We sought to determine high risk women's attitudes. This study is a qualitative examination of comments from women who participated in an online survey regarding knowledge and attitudes of preimplantation genetic diagnosis among individuals affected by hereditary breast and ovarian cancer. More than half the respondents held less favorable attitudes about the use of preimplantation genetic diagnosis for hereditary breast and ovarian cancer for both themselves and others. However, among the women who felt favorable about its usage, the majority said it became a new option for them to pursue parenthood whereas previously they had opted to not have a biological child. The high percentage of respondents who have never heard of preimplantation genetic diagnosis and who were in favor of this technology for hereditary breast and ovarian cancer indicates the need for educational campaigns to increase awareness and provide information about the procedure, access and affordability. Further research is needed to determine how this population would like this information presented to them and how best to instruct health care professionals to present this topic to women who do not know to ask about it.
Collapse
|
9
|
Chang SF. Knowledge, health beliefs and health-related behaviours of first-degree relatives of women suffering from osteoporosis in Taiwan: a questionnaire survey. J Clin Nurs 2008; 17:1280-6. [PMID: 17394538 DOI: 10.1111/j.1365-2702.2006.01859.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND No previous study has examined knowledge, health beliefs and health-related behaviours in first-degree relatives (FDRs) of osteoporosis sufferers, especially focusing on Asian women. AIM This study explored osteoporosis knowledge, beliefs and behaviours of women with a family history of osteoporosis, and drew a comparison with women with no such history. DESIGN This study recruited women at a large public health centre in northern Taiwan. A questionnaire was applied on FDRs and non-FDRs women with a focus on osteoporosis knowledge, health beliefs and behaviours. Descriptive analysis was initially conducted. Differences between FDRs and non-FDRs were rated via Student's t-tests for continuous variables and the chi-squared test for categorical variables. RESULTS Overall, most of the participants were aware of some osteoporosis-related information but the proportions of correct responses to the questions that tested knowledge between FDRs and non-FDRs were only 44.0% and 42%, respectively. Meanwhile, participants in the FDRs group not only reported higher concern in developing the disease, but also perceived higher barriers compared with the non-FDRs group. As the study demonstrates, for health-related behaviours, the FDRs group did not undertake actual preventive behaviours, and only bone mineral density screening behaviour differed significantly from the non-FDRs group. CONCLUSIONS This study highlights the inadequate information on osteoporosis and constraining beliefs of FDRs women. Additionally, as preventative behaviours for osteoporosis were not noted in FDRs group, community health nurses and researchers should make efforts to assist and encourage women to take practical preventative behaviours. RELEVANCE TO CLINICAL PRACTICE This investigation reviews the knowledge, beliefs and behaviours of the FDRs group for Taiwanese women with osteoporosis. The results of this work can be used to provide effective implementation guidelines for preventing osteoporosis especially for women with a family history of the disease.
Collapse
Affiliation(s)
- Shu-Fang Chang
- Department of Industrial Education, National Taiwan Normal University, Taiwan.
| |
Collapse
|
10
|
Jones KO, Denham BE, Springston JK. Differing effects of mass and interpersonal communication on breast cancer risk estimates: an exploratory study of college students and their mothers. HEALTH COMMUNICATION 2007; 21:165-75. [PMID: 17523862 DOI: 10.1080/10410230701307253] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Research has demonstrated that women tend to overestimate the percentage of all breast cancers that result from genetic predispositions, and this article examines the knowledge of college students, as well as their mothers, on this subject, applying uncertainty management (Brashers, 2001) as the theoretical framework. The authors build on the literature by studying (a) the types of media outlets college students and their mothers use for securing information, and (b) the types of articles and programs within those outlets that may affect risk perceptions. The authors also address associations between these mass communication measures and interpersonal sources of information in the context of risk estimation. Respondents exposed to media reports about the role of genetics in breast cancer, in addition to study participants who had discussed this role within the family, tended to overestimate measures of genetic risk. Conversely, those who had attended to media reports about screening practices tended to offer lower risk estimates, indicating that such reports may have positioned genetics as just one factor in the overall equation of breast cancer risk. The authors discuss the implications of these and other findings for communication scholars and health practitioners.
Collapse
Affiliation(s)
- Karyn Ogata Jones
- Department of Communication Studies, Clemson University, Clemson, South Carolina 29634, USA.
| | | | | |
Collapse
|
11
|
Tiller K, Meiser B, Gould L, Tucker K, Dudding T, Franklin J, Friedlander M, Andrews L. Knowledge of risk management strategies, and information and risk management preferences of women at increased risk for ovarian cancer. Psychooncology 2005; 14:249-61. [PMID: 15386771 DOI: 10.1002/pon.840] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Little research is available on the level of knowledge about ovarian cancer risk management options in women at increased risk for this disease. The study objectives were to evaluate this together with the information and ovarian cancer risk management preferences of high-risk women. One hundred and twenty-nine women were assessed after their attendance at one of six familial cancer clinics in relation to knowledge of surveillance and/or preventative strategies for reduction of ovarian cancer risk, preferences for particular strategies, and information preferences. Screening was selected by 57 (44%) women as the preferred risk management option. One hundred and five women (82%) indicated a wish for as much information as possible about ovarian cancer, including both good and bad outcomes and 114 (89%) reported a preference for sharing treatment decisions with their health professional. Participants' knowledge about ovarian cancer risk management options was significantly associated with educational levels (Z = -3.2, p=0.001) and whether or not ovarian cancer was included in the family history (Z = -2.3, p = 0.018). Findings from this present study indicate that women at increased risk of ovarian cancer who attend familial cancer clinics want as much information as possible about this disease and they want to be involved in the decision-making process. Women who reported a lower level of education (no post-school qualifications) may be most likely to benefit from additional educational strategies designed to supplement genetic counseling to improve their knowledge levels.
Collapse
MESH Headings
- Adult
- Aged
- Breast Neoplasms/genetics
- Breast Neoplasms/prevention & control
- Breast Neoplasms/psychology
- Choice Behavior
- Colorectal Neoplasms, Hereditary Nonpolyposis/genetics
- Colorectal Neoplasms, Hereditary Nonpolyposis/prevention & control
- Colorectal Neoplasms, Hereditary Nonpolyposis/psychology
- Contraceptives, Oral/administration & dosage
- Decision Support Techniques
- Female
- Genes, Dominant
- Genetic Carrier Screening
- Genetic Predisposition to Disease/genetics
- Genetic Predisposition to Disease/psychology
- Health Knowledge, Attitudes, Practice
- Humans
- Mass Screening/psychology
- Middle Aged
- Neoplasms, Glandular and Epithelial/genetics
- Neoplasms, Glandular and Epithelial/prevention & control
- Neoplasms, Glandular and Epithelial/psychology
- Neoplastic Syndromes, Hereditary/genetics
- Neoplastic Syndromes, Hereditary/prevention & control
- Neoplastic Syndromes, Hereditary/psychology
- New South Wales
- Oncology Service, Hospital/statistics & numerical data
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/prevention & control
- Ovarian Neoplasms/psychology
- Ovariectomy/psychology
- Patient Acceptance of Health Care/psychology
- Patient Education as Topic
- Patient Participation/psychology
- Risk Assessment
- Risk Reduction Behavior
- Victoria
Collapse
Affiliation(s)
- K Tiller
- Department of Medical Oncology, Prince of Wales Hospital, Sydney, Australia.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Welkenhuysen M, Evers-Kiebooms G. The Reactions of General Practitioners, Nurses and Midwives in Flanders Concerning Breast Cancer Risks in a High-Risk Situation. Public Health Genomics 2004; 6:206-13. [PMID: 15331866 DOI: 10.1159/000079382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To investigate the reactions of general practitioners (GPs), nurses and midwives concerning the cancer risks in a high-risk family. METHODS Questionnaires were sent to 356 GPs, 881 nurses and 119 midwives. RESULTS The response rate was 60% for GPs, 58% for midwives and 33% for nurses. The breast cancer risk of an unaffected patient from a high-risk family as well as the risk of her daughter were mostly (>80%) correctly evaluated as increased. The percentage answering 'increased risk' dropped to 40% for the daughters of the patient's brother. Half of the GPs and nurses/midwives explicitly mentioned that a predictive DNA test was available. Less than one third would recommend such a test for a young child. Reluctance was also observed regarding prophylactic mastectomy. CONCLUSION These results should be taken into account in genetic education initiatives for GPs, nurses and midwives.
Collapse
|
13
|
Pasacreta JV. Psychosocial issues associated with genetic testing for breast and ovarian cancer risk: an integrative review. Cancer Invest 2003; 21:588-623. [PMID: 14533449 DOI: 10.1081/cnv-120022380] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The identification of the BRCA1/2 genes, and their possible etiologic relationship with various forms of inherited cancer, has been recognized universally as a cornerstone in the search for cancer's genetic link and has made it possible to identify specific individuals and families who harbor a mutation in one of these predisposition genes. Genetic testing for breast and ovarian cancer susceptibility may pose unanticipated psychological and social problems. Because of the recent availability of predisposition genetic testing, research efforts have begun to investigate factors that may influence an individual's intention to undergo testing and the psychosocial sequelae associated with testing. The purpose of this article is to provide an integrative review of the literature that will delineate what is currently known about the psychosocial issues associated with genetic testing for breast and ovarian cancer risk. Important generalizations from the literature include: (a) a positive test for breast cancer susceptibility may ignite a psychological response similar to the diagnosis of breast cancer itself; (b) there is likely a subset of individuals at increased risk for hereditary breast and ovarian cancer who are also at risk for sustained psychosocial problems; (c) available literature challenges a common notion that only individuals with a positive test result will need psychosocial services; and (d) at-risk individuals are basing health care decisions on genetic testing information, thus they are making important decisions under conditions of uncertainty. Clinical issues and directions for future research were highlighted.
Collapse
|
14
|
Bluman LG, Rimer BK, Regan Sterba K, Lancaster J, Clark S, Borstelmann N, Iglehart JD, Winer EP. Attitudes, knowledge, risk perceptions and decision-making among women with breast and/or ovarian cancer considering testing for BRCA1 and BRCA2 and their spouses. Psychooncology 2003; 12:410-27. [PMID: 12833555 DOI: 10.1002/pon.653] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A limited number of studies have examined the involvement of spouses in the decision-making process for genetic testing as well as impact of the actual testing. This report presents data from 40 women with a personal history of breast and/or ovarian cancer who were considering genetic testing for BRCA1 and BRCA2 and their spouses. We examined knowledge and attitudes regarding genetic testing for breast cancer susceptibility, perceptions of the likelihood that their wives (the women) had a BRCA1 or BRCA2 mutation, pros and cons of genetic testing, spouses' satisfaction with their involvement in the decision-making process and additional resources they would find helpful. Knowledge about cancer genetics and genetic testing for BRCA1 and BCA2 was limited among both women and their spouses. Up to one-third of spouses indicated that they would like to avail themselves of additional sources of information about BRCA1 and BRCA2 testing. Most spouses indicated that they thought their wives had a mutation in BRCA1 or BRCA2 and that their wives' breast cancers would recur. Pros of genetic testing were emphasized more than cons among both parties. Overall, spouses were satisfied with their role in the decision-making process. Future interventions to improve the decision-making process regarding genetic testing for breast cancer susceptibility should be undertaken.
Collapse
|
15
|
Hallowell N, Foster C, Ardern-Jones A, Eeles R, Murday V, Watson M. Genetic testing for women previously diagnosed with breast/ovarian cancer: examining the impact of BRCA1 and BRCA2 mutation searching. GENETIC TESTING 2003; 6:79-87. [PMID: 12215246 DOI: 10.1089/10906570260199320] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This study sought to investigate the impact of BRCA1 and BRCA2 mutation searching on women previously diagnosed with breast or ovarian cancer. In-depth interviews were undertaken with 30 women who had undergone a BRCA1 and BRCA2 mutation search within the clinical setting. The main reasons reported for undergoing mutation searching were: to provide genetic information for other family members, general altruism, curiosity about the aetiology of cancer, and to provide information to facilitate risk management decisions. In the main, the process of undergoing genetic testing was not experienced as anxiety provoking. The benefit of receiving a result confirming the presence of a genetic mutation was seen as an end to uncertainty, whereas the costs included difficulties in disclosing information to kin and potentially increased anxiety about one's own or others' cancer risks. Women receiving an inconclusive test result reported a range of emotional reactions. There was evidence that some women misunderstood the meaning of this result, interpreting it as definitive confirmation that a cancer-predisposing mutation was not present within the family. It is concluded that women with cancer who participate in BRCA1 and BRCA2 testing need to receive clear information about the meaning and implications of the different types of test results. Some recommendations for clinical practice are discussed.
Collapse
Affiliation(s)
- N Hallowell
- The Institute of Cancer Research, Royal Marsden Hospital, London, UK
| | | | | | | | | | | |
Collapse
|
16
|
Strecker MN, Williams AJ, Bondy M, Johnston DA, Northrup H. Knowledge and Attitudes of Hispanic Women and Their Health Care Providers about Breast Cancer Risk Factors and Screening. Public Health Genomics 2002; 5:222-31. [PMID: 14960876 DOI: 10.1159/000066685] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The purpose of our study was to develop and evaluate an educational program for health care providers and patients on the topics of general breast cancer risk factors, breast cancer genetics, and breast cancer screening recommendations. The program was designed with specific emphasis on addressing the needs of medically underserved Hispanic women in Southern Texas. We also identified and compared perceptions of potential barriers to breast cancer screening. METHODS The educational program was piloted with patient and health care provider focus groups. After incorporating modifications suggested by the focus groups, 103 patients and 94 health care providers (HCPs) from community health clinics in Harris County, Tex., were recruited to participate in the study. Changes in knowledge were measured through the use of pre- and postseminar questionnaires. RESULTS The program identified various misconceptions about breast cancer in representative groups of patients and HCPs. Comparison of pre- and post-test scores indicated that both groups made significant gains in knowledge about breast cancer and breast cancer screening. Participant evaluations indicated that the seminar was informative and interesting. Both patients and HCPs agreed that the cost of breast cancer screening and the lack of sufficient bilingual HCPs were 'major' barriers to obtaining breast cancer screening, but had differing opinions regarding other potential barriers. CONCLUSIONS We have developed an effective method of education about breast cancer risk factors and screening for two groups: Hispanic women of lower educational and socioeconomic levels, and the HCPs who serve them. Based on the successful reception of our program, we propose extending it to other areas of Texas with demographics similar to those of the study population.
Collapse
Affiliation(s)
- Michelle N Strecker
- Department of Pediatrics, Division of Medical Genetics, The University of Texas Medical School at Houston, Houston, 77030, USA
| | | | | | | | | |
Collapse
|
17
|
Lobb EA, Butow PN, Meiser B, Barratt A, Gaff C, Young MA, Kirk J, Suthers GK, Tucker K. Tailoring communication in consultations with women from high risk breast cancer families. Br J Cancer 2002; 87:502-8. [PMID: 12189544 PMCID: PMC2376156 DOI: 10.1038/sj.bjc.6600484] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2001] [Revised: 04/23/2002] [Accepted: 06/06/2002] [Indexed: 11/09/2022] Open
Abstract
This multicentre study examined the influence of patient demographic, disease status and psychological variables on clinical geneticists/genetic counsellors (consultants) behaviours in initial consultations with women from high-risk breast cancer families. One hundred and fifty-eight women completed a pre-clinic self-report questionnaire. The consultations were audiotaped, transcribed verbatim and coded. Consultants did not vary their behaviour according to women's expectations. However, significantly more aspects of genetic testing were discussed with women who were affected with breast cancer (P<0.001), screening and management with unaffected women (P=0.01) and breast cancer prevention with younger women (P=0.01). Prophylactic mastectomy was discussed more frequently with women with medical and allied health training (P=0.02), and prophylactic oophorectomy with women affected with breast cancer (P=0.03), those in non-professional occupations (P=0.04) and with a family history of breast and ovarian cancer (P<0.001). Consultants used significantly more behaviours to facilitate understanding with women who were in non-professional occupations (P=0.04); facilitated active patient involvement more with women affected with breast cancer (P<0.001) and used more supportive and counselling behaviours with affected women (P=0.02). This study showed that patient demographics were more likely to predict consultants' communication behaviours than the woman's psychological status. Methods to facilitate assessment of psychological morbidity are needed to allow more tailored communication.
Collapse
Affiliation(s)
- E A Lobb
- Medical Psychology Research Unit, Department of Psychological Medicine, University of Sydney, Sydney, New South Wales 2006, Australia.
| | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Meiser B, Butow P, Barratt A, Gattas M, Gaff C, Haan E, Gleeson M, Dudding T, Tucker K. Risk perceptions and knowledge of breast cancer genetics in women at increased risk of developing hereditary breast cancer. Psychol Health 2001. [DOI: 10.1080/08870440108405508] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
19
|
Abstract
PURPOSE To identify BRCA1/2 knowledge, genetic testing intentions, and communication patterns in breast cancer survivors (survivors). METHODS A population-based survey was conducted of 276 female survivors diagnosed between the ages of 40 and 49 and living 5 to 10 years postdiagnosis. RESULTS Of the 79% who responded, 8% spoke with health care providers and 53% spoke with relatives about testing. Few (26%) correctly answered over half the BRCA knowledge questions. Intention to obtain testing varied (26-67%), depending on insurance coverage. CONCLUSION Health care providers and survivors seldom discuss BRCA testing. Providing information to survivors would increase their ability to make informed testing decisions.
Collapse
Affiliation(s)
- C M Velicer
- Department of Epidemiology, University of Washington, Group Health Cooperative of Puget Sound, Seattle, Washington, USA
| | | |
Collapse
|
20
|
Evers-Kiebooms G, Welkenhuysen M, Claes E, Decruyenaere M, Denayer L. The psychological complexity of predictive testing for late onset neurogenetic diseases and hereditary cancers: implications for multidisciplinary counselling and for genetic education. Soc Sci Med 2000; 51:831-41. [PMID: 10972428 DOI: 10.1016/s0277-9536(00)00064-2] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Increasing knowledge about the human genome has resulted in the availability of a steadily increasing number of predictive DNA-tests for two major categories of diseases: neurogenetic diseases and hereditary cancers. The psychological complexity of predictive testing for these late onset diseases requires careful consideration. It is the main aim of the present paper to describe this psychological complexity, which necessitates an adequate and systematic multidisciplinary approach, including psychological counselling, as well as ongoing education of professionals and of the general public. Predictive testing for neurogenetic diseases--in an adequate counselling context--so far elicits optimism regarding the short- and mid-term impact of the predictive test result. The psychosocial impact has been most widely studied for Huntington's disease. Longitudinal studies are of the utmost importance in evaluating the long-term impact of predictive testing for neurogenetic diseases on the tested person and his/her family. Given the more recent experience with predictive DNA-testing for hereditary cancers, fewer published scientific data are available. Longitudinal research on the mid- and long-term psychological impact of the predictive test result is essential. Decision making regarding health surveillance or preventive surgery after being detected as a carrier of one of the relevant mutations should receive special attention. Tailoring the professional approach--inside and outside genetic centres--to the families' needs is a continuous challenge. Even if a continuous effort is made, several important questions remain unanswered, last but not least the question regarding the best strategy to guarantee that the availability of predictive genetic testing results in a reduction of suffering caused by genetic disease and in an improvement of the quality of life of families confronted with genetic disease.
Collapse
Affiliation(s)
- G Evers-Kiebooms
- Psychosocial Genetics Unit, Center for Human Genetics, K.U. Leuven, Belgium
| | | | | | | | | |
Collapse
|
21
|
Abstract
BACKGROUND Molecular alterations in proto-oncogenes, tumour suppressor genes, and genes that function in DNA damage recognition and repair are considered to be hallmarks of a carcinogenic process, including breast carcinogenesis. METHODS A computer-assisted search of the English literature (Medline database, 1990-1999) was performed, followed by a manual search of the reference list of pertinent articles retrieved. RESULTS Hereditary breast cancer accounts for 5-10 per cent of all breast cancer cases. About 90 per cent of hereditary breast cancers involve mutation of the BRCA1 and/or BRCA2 genes. Other cancer-related genes (including myc, c-erbB2, Tsg101 and Mdgi) are involved in breast carcinogenesis, but they do not give rise to familial breast cancer syndromes. Risk estimation is the most important clinical implication. Management options for the high-risk mutation carriers include cancer surveillance and preventive strategies (prophylactic surgery or chemoprevention). CONCLUSION Despite inadequate knowledge about the genetic predisposition to breast cancer and its clinical implications, the demand for genetic testing is likely to expand rapidly. In addition to risk estimation, cancer surveillance and preventive strategies, gene therapy offers a new and theoretically attractive approach to breast cancer management.
Collapse
Affiliation(s)
- G H Sakorafas
- Department of Surgery, 251 Hellenic Air Force Hospital, Messogion and Katehaki, Athens 115 25, Greece
| | | |
Collapse
|
22
|
Rees CE, Bath PA. Meeting the information needs of adult daughters of women with early breast cancer. Patients and health care professionals as information providers. Cancer Nurs 2000; 23:71-9. [PMID: 10673810 DOI: 10.1097/00002820-200002000-00012] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study explored the information needs of adult daughters whose mothers had early breast cancer and illustrated the information flows between the daughters and two information providers: patients and health care professionals (HCPs). Participants were 97 daughters, who completed a 30-time self-administered questionnaire, a tool designed to identify the information needs of daughters and their communication channels. Daughters also completed the Miller Behavioral Style Scale, a scale used to determine the information-seeking behavior of individuals under threat. Descriptive statistics revealed that the information flows between women with breast cancer and daughters participating in this study were good. Most of the daughters received information from their mothers and asked their mothers questions. Few daughters thought their mothers avoided giving them information. The vast majority of the daughters, however, sought information from sources other than their mothers, indicating that the mothers alone did not satisfy their information needs. More than half of the daughters participating in this study accompanied their mothers to their medical consultations and received information from HCPs. Logistic regression indicated that the communication flows between patients, HCPs, and adult daughters of women with breast cancer depended on a number of factors, in particular, on the amount of communication desired by women with breast cancer.
Collapse
Affiliation(s)
- C E Rees
- Division of Psychiatry, University of Nottingham, England
| | | |
Collapse
|
23
|
Bluman LG, Rimer BK, Berry DA, Borstelmann N, Iglehart JD, Regan K, Schildkraut J, Winer EP. Attitudes, knowledge, and risk perceptions of women with breast and/or ovarian cancer considering testing for BRCA1 and BRCA2. J Clin Oncol 1999; 17:1040-6. [PMID: 10071299 DOI: 10.1200/jco.1999.17.3.1040] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE This study examined baseline knowledge, beliefs, and risk perceptions among a group of 200 women with breast and/or ovarian cancer who participated in a trial designed to improve decision making about genetic testing for BRCA1 and BRCA2. PATIENTS AND METHODS Women were identified by self-referral, physician referral, and tumor registry extraction and invited to participate in a randomized trial in which testing for BRCA1 and BRCA2 was offered free of charge. Subjects completed baseline questionnaires and interviews that assessed knowledge, attitudes, and perceptions of risk of having an alteration in BRCA1 or BRCA2. RESULTS Sixty percent of women overestimated their chances of having a BRCA1 or BRCA2 mutation compared with estimates from a BRCA1/BRCA2 risk model. Women who have at least three relatives with breast or ovarian cancer were one third (95% confidence interval, 0.2 to 0.6) as likely to overestimate their risk of having a BRCA1 or BRCA2 mutation compared with women who have two or fewer affected relatives. Knowledge was limited about BRCA1 and BRCA2 mutations and cancer risk associated with gene mutations. Eighty-four percent of the women indicated a probable or definite interest in testing. CONCLUSION A high proportion of the high-risk women in this study had knowledge deficits about BRCA1 and BRCA2 and overestimated their risk of having a mutation. Although some degree of caution should be used in generalizing the results of this study to practice settings, the data provide insight into the challenges clinicians will face in communicating with patients about cancer genetics.
Collapse
Affiliation(s)
- L G Bluman
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Mouchawar J, Byers T, Cutter G, Dignan M, Michael S. A study of the relationship between family history of breast cancer and knowledge of breast cancer genetic testing prerequisites. CANCER DETECTION AND PREVENTION 1999; 23:22-30. [PMID: 9892987 DOI: 10.1046/j.1525-1500.1999.00065.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Awareness of hereditary breast cancer genetic testing, of breast cancer risk factors, and of increased level of risk based on family history are necessary before women can seek out genetic services. The aim of this paper is to describe the relationships between family history of breast cancer and awareness of genetic testing, knowledge of breast cancer risk factors, and perceived lifetime risk of breast cancer. An anonymous survey was administered by mail to a random sample of 600 women, 200 from each of three breast cancer family history groups (none, intermediate, and strong), drawn from a population-based registry of 240,000 women enrolled in a mammography screening program in the Denver Metropolitan area in Colorado. Awareness of genetic testing for breast cancer risk assessment was found to be significantly associated with family history of breast cancer, increasing from 35% in the lowest family history risk group to 67% in the group with the strongest familial risk (p = 0.002). In all family history groups, nearly 70% of respondents viewed high-fat diet and smoking as being important in relation to breast cancer risk, but alcohol was seen as being only somewhat important or not important by almost half of all respondents. Having a mother or sister with breast cancer was reported as being extremely or very important by nearly all respondents, regardless of family history. As expected, perceived lifetime risk for developing breast cancer was associated with family history (p = 0.001), but the perception of the lifetime risk for breast cancer was much higher among all of the family history groups than their true risk. In conclusion, educational interventions are needed to heighten women's awareness of genetic testing, to clarify women's knowledge of breast cancer risk factors, especially alcohol, and to reassure many women that their actual breast cancer risk is lower than they might perceive.
Collapse
Affiliation(s)
- J Mouchawar
- Department of Preventive Medicine & Biometrics, University of Colorado School of Medicine, Denver, Colorado 80262, USA
| | | | | | | | | |
Collapse
|