Abstract
Purpose: To identify members of hereditary breast and ovarian cancer families who are at risk far adverse psychologic effects of genetic testing. Patients and Methods: A prospective cohort study with baseline (preeducation) assessments of predictor variables (ie, sociodemographic factors, cancer history, and cancer-related stress symptoms) was performed. The primary outcome variable (presence of depressive symptoms) was assessed at baseline and at 1- and 6-month follow-up evaluations. Participants were 327 adult male and female members of BRCA1- and BRCA2-linked hereditary breast and ovarian cancer families, who were identified as carriers, noncarriers, or decliners of genetic testing. Results: The presence of cancer-related stress symptoms at baseline was strongly predictive of the onset of depressive symptoms in family members who were invited but declined testing. Among persons who reported high baseline levels of stress, depression rates in decliners increased from 26% at baseline to 47% at 1-month follow-up; depression rates in noncarriers decreased and in carriers showed no change (odds ratio [OR] for decliners v noncarriers = 8.0; 95% confidence interval [CI], 1.9 to 33.5; P = .0004). These significant differences in depression rates were still evident at the 6-month follow-up evaluation (P = .04). Conclusion: In BRCA1/2-linked families, persons with high levels of cancer-related stress who decline genetic testing may be at risk for depression. These family members may benefit from education and counseling, even if they ultimately elect not to be tested, and should be monitored far potential adverse effects.
| Original language | English |
|---|---|
| Pages (from-to) | 1650-1654 |
| Number of pages | 5 |
| Journal | Journal of Clinical Oncology |
| Volume | 16 |
| Issue number | 5 |
| State | Published - May 1998 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Cancer Research
- Oncology
Cite this
What you don't know can hurt you : Adverse psychologic effects in members of BRCA1-linked and BRCA2-linked families who decline genetic testing. / Lerman, Caryn; Hughes, Chanita; Lemon, Stephen J.; Main, David; Snyder, Carrie; Durham, Carolyn; Narod, Steven; Lynch, Henry T.
In: Journal of Clinical Oncology, Vol. 16, No. 5, 05.1998, p. 1650-1654.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - What you don't know can hurt you
T2 - Adverse psychologic effects in members of BRCA1-linked and BRCA2-linked families who decline genetic testing
AU - Lerman, Caryn
AU - Hughes, Chanita
AU - Lemon, Stephen J.
AU - Main, David
AU - Snyder, Carrie
AU - Durham, Carolyn
AU - Narod, Steven
AU - Lynch, Henry T.
PY - 1998/5
Y1 - 1998/5
N2 - Purpose: To identify members of hereditary breast and ovarian cancer families who are at risk far adverse psychologic effects of genetic testing. Patients and Methods: A prospective cohort study with baseline (preeducation) assessments of predictor variables (ie, sociodemographic factors, cancer history, and cancer-related stress symptoms) was performed. The primary outcome variable (presence of depressive symptoms) was assessed at baseline and at 1- and 6-month follow-up evaluations. Participants were 327 adult male and female members of BRCA1- and BRCA2-linked hereditary breast and ovarian cancer families, who were identified as carriers, noncarriers, or decliners of genetic testing. Results: The presence of cancer-related stress symptoms at baseline was strongly predictive of the onset of depressive symptoms in family members who were invited but declined testing. Among persons who reported high baseline levels of stress, depression rates in decliners increased from 26% at baseline to 47% at 1-month follow-up; depression rates in noncarriers decreased and in carriers showed no change (odds ratio [OR] for decliners v noncarriers = 8.0; 95% confidence interval [CI], 1.9 to 33.5; P = .0004). These significant differences in depression rates were still evident at the 6-month follow-up evaluation (P = .04). Conclusion: In BRCA1/2-linked families, persons with high levels of cancer-related stress who decline genetic testing may be at risk for depression. These family members may benefit from education and counseling, even if they ultimately elect not to be tested, and should be monitored far potential adverse effects.
AB - Purpose: To identify members of hereditary breast and ovarian cancer families who are at risk far adverse psychologic effects of genetic testing. Patients and Methods: A prospective cohort study with baseline (preeducation) assessments of predictor variables (ie, sociodemographic factors, cancer history, and cancer-related stress symptoms) was performed. The primary outcome variable (presence of depressive symptoms) was assessed at baseline and at 1- and 6-month follow-up evaluations. Participants were 327 adult male and female members of BRCA1- and BRCA2-linked hereditary breast and ovarian cancer families, who were identified as carriers, noncarriers, or decliners of genetic testing. Results: The presence of cancer-related stress symptoms at baseline was strongly predictive of the onset of depressive symptoms in family members who were invited but declined testing. Among persons who reported high baseline levels of stress, depression rates in decliners increased from 26% at baseline to 47% at 1-month follow-up; depression rates in noncarriers decreased and in carriers showed no change (odds ratio [OR] for decliners v noncarriers = 8.0; 95% confidence interval [CI], 1.9 to 33.5; P = .0004). These significant differences in depression rates were still evident at the 6-month follow-up evaluation (P = .04). Conclusion: In BRCA1/2-linked families, persons with high levels of cancer-related stress who decline genetic testing may be at risk for depression. These family members may benefit from education and counseling, even if they ultimately elect not to be tested, and should be monitored far potential adverse effects.
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UR - http://www.scopus.com/inward/citedby.url?scp=0031833970&partnerID=8YFLogxK
M3 - Article
C2 - 9586874
AN - SCOPUS:0031833970
VL - 16
SP - 1650
EP - 1654
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 5
ER -