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Palmero EI, Campacci N, Schüler-Faccini L, Giugliani R, Rocha JCCD, Vargas FR, Ashton-Prolla P. Cancer-related worry and risk perception in Brazilian individuals seeking genetic counseling for hereditary breast cancer. Genet Mol Biol 2020; 43:e20190097. [PMID: 32325485 PMCID: PMC7210979 DOI: 10.1590/1678-4685-gmb-2019-0097] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 11/27/2019] [Indexed: 02/07/2023] Open
Abstract
In Brazil, the population in general has little knowledge about genetic risks, as well as regarding the role and importance of the Cancer Genetic Counseling (CGC). The goal of this study was to evaluate cancer-related worry and cancer risk perception during CGC sessions in Brazilian women at-risk for hereditary breast cancer. This study was performed in 264 individuals seeking CGC for hereditary breast cancer. Both cancer-affected and unaffected individuals were included. As results, individuals with and without cancer reported different motivations for seeking CGC and undergoing genetic testing. A correlation was observed between age at the first CGC session and age at which the closest relative was diagnosed with cancer. Multivariate analysis showed that educational level, cancer risk discussion within the family, and number of deaths by cancer among first-degree relatives influenced positively the cancer risk perception. In conclusion, the results of this study indicate that cancer-related worry and cancer risk perception are significant aspects of morbidity in individuals seeking CGC, whether they are cancer-affected or unaffected. CGC has an important role in health education and cancer prevention for its potential of promoting an accurate perception of the risk.
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Affiliation(s)
- Edenir Inêz Palmero
- Universidade Federal do Rio Grande do Sul, Departamento de Genética, Porto Alegre, RS, Brazil
| | - Natalia Campacci
- Hospital de Câncer de Barretos, Centro de Pesquisa em Oncologia Molecular, Barretos, SP, Brazil
| | - Lavinia Schüler-Faccini
- Universidade Federal do Rio Grande do Sul, Departamento de Genética, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil
| | - Roberto Giugliani
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil
| | | | | | - Patricia Ashton-Prolla
- Universidade Federal do Rio Grande do Sul, Departamento de Genética, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil
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Campacci N, de Lima JO, Carvalho AL, Michelli RD, Haikel R, Mauad E, Viana DV, Melendez ME, Vazquez FDL, Zanardo C, Reis RM, Rossi BM, Palmero EI. Identification of hereditary cancer in the general population: development and validation of a screening questionnaire for obtaining the family history of cancer. Cancer Med 2017; 6:3014-3024. [PMID: 29055968 PMCID: PMC5727305 DOI: 10.1002/cam4.1210] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 08/22/2017] [Accepted: 08/23/2017] [Indexed: 12/14/2022] Open
Abstract
One of the challenges for Latin American countries is to include in their healthcare systems technologies that can be applied to hereditary cancer detection and management. The aim of the study is to create and validate a questionnaire to identify individuals with possible risk for hereditary cancer predisposition syndromes (HCPS), using different strategies in a Cancer Prevention Service in Brazil. The primary screening questionnaire (PSQ) was developed to identify families at‐risk for HCPS. The PSQ was validated using discrimination measures, and the reproducibility was estimated through kappa coefficient. Patients with at least one affirmative answer had the pedigree drawn using three alternative interview approaches: in‐person, by telephone, or letter. Validation of these approaches was done. Kappa and intraclass correlation coefficients were used to analyze data's reproducibility considering the presence of clinical criteria for HCPS. The PSQ was applied to a convenience sample of 20,000 women of which 3121 (15.6%) answered at least one affirmative question and 1938 had their pedigrees drawn. The PSQ showed sensitivity and specificity scores of 94.4% and 75%, respectively, and a kappa of 0.64. The strategies for pedigree drawing had reproducibility coefficients of 0.976 and 0.850 for the telephone and letter approaches, respectively. Pedigree analysis allowed us to identify 465 individuals (24.0%) fulfilling at least one clinical criterion for HCPS. The PSQ fulfills its function, allowing the identification of HCPS at‐risk families. The use of alternative screening methods may reduce the number of excluded at‐risk individuals/families who live in locations where oncogenetic services are not established.
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Affiliation(s)
- Natalia Campacci
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | - Juliana O de Lima
- Center of Molecular Diagnostics, Barretos Cancer Hospital, Barretos, Brazil
| | - André L Carvalho
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | | | - Rafael Haikel
- Prevention Department, Barretos Cancer Hospital, Barretos, Brazil
| | - Edmundo Mauad
- Oncogenetics Department, Barretos Cancer Hospital, Barretos, Brazil.,Prevention Department, Barretos Cancer Hospital, Barretos, Brazil
| | - Danilo V Viana
- Oncogenetics Department, Barretos Cancer Hospital, Barretos, Brazil
| | - Matias E Melendez
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | | | - Cleyton Zanardo
- Center for Research Support - NAP, Barretos Cancer Hospital, Barretos, Brazil
| | - Rui M Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.,Center of Molecular Diagnostics, Barretos Cancer Hospital, Barretos, Brazil.,Life and Health Sciences Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | | | - Edenir I Palmero
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.,Center of Molecular Diagnostics, Barretos Cancer Hospital, Barretos, Brazil.,Oncogenetics Department, Barretos Cancer Hospital, Barretos, Brazil.,Barretos School of Health Sciences, Dr. Paulo Prata - FACISB, Brazil
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