Universität zu Köln

Bredart, Anne, Kop, Jean-Luc, Dick, Julia, Cano, Alejandra, De Pauw, Antoine, Anota, Amelie, Brunet, Joan ORCID: 0000-0003-1945-3512, Devilee, Peter, Stoppa-Lyonnet, Dominique, Schmutzler, Rita and Dolbeault, Sylvie (2019). Psychosocial problems in women attending French, German and Spanish genetics clinics before and after targeted or multigene testing results: an observational prospective study. BMJ Open, 9 (9). LONDON: BMJ PUBLISHING GROUP. ISSN 2044-6055

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Abstract

Objectives and setting Advances in multigene panel testing for cancer susceptibility has increased the complexity of counselling, requiring particular attention to counselees' psychosocial needs. Changes in psychosocial problems before and after genetic testing were prospectively compared between genetic test results in women tested for breast or ovarian cancer genetic susceptibility in French, German and Spanish clinics. Participants and measures Among 752 counselees consecutively approached, 646 (86%) were assessed after the initial genetic consultation (T1), including 510 (68%) affected with breast cancer, of which 460 (61%) were assessed again after receiving the test result (T2), using questionnaires addressing genetic-specific psychosocial problems (Psychosocial Aspects of Hereditary Cancer (PAHC)-six scales). Sociodemographic and clinical data were also collected. Results Seventy-nine (17.2%), 19 (4.1%), 259 (56.3%), 44 (9.6%) and 59 (12.8%) women received a BRCA1/2, another high/moderate-risk pathogenic variant (PV), negative uninformative, true negative (TN) or variant of uncertain significance result (VUS), respectively. On multiple regression analyses, compared with women receiving another result, those with a VUS decreased more in psychosocial problems related to hereditary predisposition (eg, coping with the test result) (beta=-0.11, p<0.05) and familial/social issues (eg, risk communication) (beta=-0.13, p<0.05), almost independently from their problems before testing. Women with a PV presented no change in hereditary predisposition problems and, so as women with a TN result, a non-significant increase in familial/social issues. Other PAHC scales (ie, emotions, familial cancer, personal cancer and children-related issues) were not affected by genetic testing. Conclusions In women tested for breast or ovarian cancer genetic risk in European genetics clinics, psychosocial problems were mostly unaffected by genetic testing. Apart from women receiving a VUS result, those with another test result presented unchanged needs in counselling in particular about hereditary predisposition and familial/social issues.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bredart, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Kop, Jean-Luc UNSPECIFIED UNSPECIFIED UNSPECIFIED Dick, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Cano, Alejandra UNSPECIFIED UNSPECIFIED UNSPECIFIED De Pauw, Antoine UNSPECIFIED UNSPECIFIED UNSPECIFIED Anota, Amelie UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunet, Joan UNSPECIFIED orcid.org/0000-0003-1945-3512 UNSPECIFIED Devilee, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoppa-Lyonnet, Dominique UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmutzler, Rita UNSPECIFIED UNSPECIFIED UNSPECIFIED Dolbeault, Sylvie UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-141975
DOI:	10.1136/bmjopen-2019-029926
Journal or Publication Title:	BMJ Open
Volume:	9
Number:	9
Date:	2019
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	2044-6055
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BRCA1/2 TEST RESULT; BREAST-CANCER; HEREDITARY BREAST; OVARIAN-CANCER; PSYCHOLOGICAL IMPACT; FOLLOW-UP; DISTRESS; SUSCEPTIBILITY; GUIDELINES; RECLASSIFICATION Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14197