Exploring the short-term impact of DNA-testing in breast cancer patients: The counselees' perception matters, but the actual BRCA1/2 result does not

Joel Vos*, Jan C. Oosterwijk, Encarna Gomez-Garcia, Fred H. Menko, Margriet J. Collee, Christi J. van Asperen, Anne M. Stiggelbout, Aad Tibben, AM JANSEN

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

23 Citations (Scopus)

Abstract

Objective: Previous studies suggest that learning a DNA-test-result has no direct impact on the medical-decisions and psychological well-being of counselees. Their perception, especially their recollections and interpretations of their cancer-risks and heredity, predict and/or mediate this impact. These studies were criticized for their small range of predictors, mediators, outcomes and contextual factors. We studied the short-term impact of DNA-testing with an extended model.

Methods: Three months after disclosure of BRCA1/2-test-results, we sent counselees a questionnaire about their perception, medical and psychological outcomes, and medical, familial and psychological contexts. 248 affected women participated: 30 had received pathogenic-mutations, 16 unclassified-variants and 202 uninformative-results.

Results: The actually communicated genetic-information and the contextual variables predicted the counselees' perception, but did not directly predict any outcomes. The counselees' perception predicted and/or completely mediated the counselees' medical intentions and behavior, physical and psychological life-changes, stigma, mastery, negativity and cancer-worries. Short-term distress was related to the perception not only of their own risks, but also of their relatives' risks and heredity-likelihood. Effect sizes were medium to large.

Conclusions and implications: The outcomes of DNA-testing were better predicted by the counselees' perception than by the actually given genetic-information. We recommend genetic-counselors to have tailored, interactive dialogues about the counselees' perception. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)239-251
Number of pages13
JournalPatient Education and Counseling
Volume86
Issue number2
DOIs
Publication statusPublished - Feb-2012

Keywords

  • BRCA1/2
  • Risk perception
  • Breast cancer
  • Ovarian cancer
  • Oncology
  • Psychology
  • Genetic-counseling
  • COMMON-SENSE MODEL
  • PSYCHOLOGICAL IMPACT
  • RISK PERCEPTION
  • OVARIAN-CANCER
  • HEREDITARY BREAST
  • DEPRESSION SCALE
  • HOSPITAL ANXIETY
  • DECISION-MAKING
  • SUSCEPTIBILITY
  • DISTRESS

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