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Leite ACR, Suzuki DA, Pereira AAL, Machado NP, Barroso-Sousa R, Correa TS, Moura FC, Morbeck IAP, Gumz BP, Faria LDBB, Fernandes GDS, Sandoval RL. What can we learn from more than 1,000 Brazilian patients at risk of hereditary cancer? Front Oncol 2022; 12:963910. [PMID: 36132150 PMCID: PMC9484549 DOI: 10.3389/fonc.2022.963910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundIdentifying individuals at a higher risk of developing cancer is a major concern for healthcare providers. Cancer predisposition syndromes are the underlying cause of cancer aggregation and young-onset tumors in many families. Germline genetic testing is underused due to lack of access, but Brazilian germline data associated with cancer predisposition syndromes are needed.MethodsMedical records of patients referred for genetic counseling at the Oncogenetics Department at the Hospital Sírio-Libanês (Brasília, DF, Brazil) from July 2017 to January 2021 were reviewed. The clinical features and germline findings were described. Detection rates of germline pathogenic/likely pathogenic variant (P/LPV) carriers were compared between international and Brazilian guidelines for genetic testing.ResultsA total of 1,091 individuals from 985 families were included in this study. Most patients (93.5%) had a family history of cancer, including 64% with a family member under 50 with cancer. Sixty-six percent of patients (720/1091) had a personal history of cancer. Young-onset cancers (<50 years old) represented 62% of the patients affected by cancer and 17% had multiple primary cancers. The cohort included patients with 30 different cancer types. Breast cancer was the most prevalent type of cancer (52.6%). Germline testing included multigene panel (89.3%) and family variant testing (8.9%). Approximately 27% (236/879) of the tested patients harbored germline P/LPVs in cancer susceptibility genes. BRCA2, BRCA1, and TP53 were the most frequently reported genes, corresponding to 18.6%, 14.4%, and 13.5% of the positive results, respectively. Genetic testing criteria from international guidelines were more effective in identifying carriers than the Brazilian National Agency of Supplementary Health (ANS) criteria (92% vs. 72%, p<0.001). Forty-six percent of the cancer-unaffected patients who harbored a germline P/LPV (45/98) would not be eligible for genetic testing according to ANS because they did not have a family variant previously identified in a cancer-affected relative.ConclusionThe high detection rate of P/LPVs in the present study is possibly related to the genetic testing approach with multigene panels and cohort’s characteristics, represented mainly by individuals with a personal or family history of young-onset cancer. Testing asymptomatic individuals with suspicious family history may also have contributed to a higher detection rate. A significant number of carriers would not have been identified using ANS criteria for genetic testing.
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When guidelines face reality - Lynch syndrome screening in the setting of public health system in a developing country. J Community Genet 2021; 13:19-29. [PMID: 34623598 DOI: 10.1007/s12687-021-00549-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022] Open
Abstract
Lynch syndrome (LS) is the most common cause of hereditary colorectal cancer (CRC); however, it is still underrecognized and underdiagnosed. While international guidelines gravitate towards universal screening, the underuse of screening methods has been reported in real-world scenarios. This study aims to evaluate screening for LS among patients diagnosed with CRC in a public cancer center in Brazil and evaluate access to genetic counseling and testing for abnormal screens. For that purpose, all patients with CRC registered in our institution from July 2012 to December 2018 had their charts reviewed. Demographic and clinical characteristics were noted, as well as immunohistochemistry and microsatellite instability analysis results, when available. After applying exclusion criteria, a total of 1234 charts were reviewed. Among these, 257 patients were screened for LS, making up a 20.8% screening rate; when considering Jerusalem criteria, screening rate was 24.5%; for Bethesda criteria, it was 35.1%. Almost 80% of patients fulfilling Amsterdam criteria I/II were screened. There were 64 abnormal screens, from which 40 (62.5%) underwent genetic counseling and 12 (18.7%) underwent genetic testing. We concluded that overall screening rates for LS among CRC patients in a public cancer center in Brazil are low, and still very guided by stringent clinical criteria. Referral to genetic counseling and access to testing is limited, calling the whole process into question. Public policies aiming to raise awareness on hereditary cancer and include genetic testing in the public health system could help improve this scenario.
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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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4
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Vieira TA, Trapp FB, Souza CFMD, Faccini LS, Jardim LB, Schwartz IVD, Riegel M, Vargas CR, Burin MG, Leistner-Segal S, Ashton-Prolla P, Giugliani R. Information and Diagnosis Networks - tools to improve diagnosis and treatment for patients with rare genetic diseases. Genet Mol Biol 2019; 42:155-164. [PMID: 31188934 PMCID: PMC6687351 DOI: 10.1590/1678-4685-gmb-2018-0214] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/12/2018] [Indexed: 12/14/2022] Open
Abstract
Brazil is a country of continental dimensions and most genetic services are
concentrated in the Southeast and South, including the Medical Genetics Service
of the Hospital de Clínicas de Porto Alegre (MGS/HCPA). As many areas on the
country do not have adequate medical genetics support, networks were designed to
extend the service of the MGS/HCPA reference center. This paper presents the
information and diagnosis networks that have their headquarters at MGS/HCPA:
SIAT (National Information System on Teratogenic Agents),
SIEM (Information Service on Inborn Errors of Metabolism),
Alô Genética (Hello Genetics - Medical Genetics Information
Service for Primary Health Care Professionals); Rede MPS Brasil
(MPS-Mucopolysaccharidosis Brazil Network); Rede EIM Brasil
(IEM-Inborn Errors of Metabolism Brazil Network), Rede NPC
Brasil (Niemann-Pick C - NPC Brazil Network), Rede DLD
Brasil (LSD-Lysosomal Storage Disorders Brazil Network),
Rede DXB (MSUD-Maple Syrup Urine Disease Network),
RedeBRIM (Brazilian Network of Reference and Information in
Microdeletion Syndromes Project), Rede Neurogenética
(Neurogenetics Network), and Rede Brasileira de Câncer
Hereditário (Brazilian Hereditary Cancer Network). These tools are
very useful to provide access to a qualified information and/or diagnostic
service for specialized and non-specialized health services, bypassing
difficulties that preclude patients to access reference centers.
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Affiliation(s)
- Taiane Alves Vieira
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Research and Postgraduate Group - Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | | | | | - Lavínia Schuler Faccini
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Department of Genetics - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Laura Bannach Jardim
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Department of Internal Medicine - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ida Vanessa Doederlein Schwartz
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Department of Genetics - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Mariluce Riegel
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Carmen Regla Vargas
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Maira Graeff Burin
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Sandra Leistner-Segal
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Patrícia Ashton-Prolla
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Research and Postgraduate Group - Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Department of Genetics - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Roberto Giugliani
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.,Department of Genetics - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Palmero EI, Galvão HCR, Fernandes GC, Paula AED, Oliveira JC, Souza CP, Andrade CE, Romagnolo LGC, Volc S, C Neto M, Sabato C, Grasel R, Mauad E, Reis RM, Michelli RAD. Oncogenetics service and the Brazilian public health system: the experience of a reference Cancer Hospital. Genet Mol Biol 2016; 39:168-77. [PMID: 27192127 PMCID: PMC4910553 DOI: 10.1590/1678-4685-gmb-2014-0364] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 07/21/2015] [Indexed: 11/22/2022] Open
Abstract
The identification of families at-risk for hereditary cancer is extremely important
due to the prevention potential in those families. However, the number of Brazilian
genetic services providing oncogenetic care is extremely low for the continental
dimension of the country and its population. Therefore, at-risk patients do not
receive appropriate assistance. This report describes the creation, structure and
management of a cancer genetics service in a reference center for cancer prevention
and treatment, the Barretos Cancer Hospital (BCH). The Oncogenetics Department (OD)
of BCH offers, free of charge, to all patients/relatives with clinical criteria, the
possibility to perform i) genetic counseling, ii) preventive examinations and iii)
genetic testing with the best quality standards. The OD has a multidisciplinary team
and is integrated with all specialties. The genetic counseling process consists
(mostly) of two visits. In 2014, 614 individuals (371 families) were seen by the OD.
To date, over 800 families were referred by the OD for genetic testing. The support
provided by the Oncogenetics team is crucial to identify at-risk individuals and to
develop preventive and personalized behaviors for each situation, not only to the
upper-middle class population, but also to the people whose only possibility is the
public health system.
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Affiliation(s)
- Edenir I Palmero
- Centro de Pesquisa em Oncologia Molecular, Hospital de Câncer de Barretos, Barretos, SP, Brazil.,Faculdade de Ciências de Saúde de Barretos, Dr. Paulo Prata - FACISB, Barretos, SP, Brazil.,Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
| | - Henrique C R Galvão
- Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
| | - Gabriela C Fernandes
- Centro de Pesquisa em Oncologia Molecular, Hospital de Câncer de Barretos, Barretos, SP, Brazil.,Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
| | - André E de Paula
- Centro de Pesquisa em Oncologia Molecular, Hospital de Câncer de Barretos, Barretos, SP, Brazil.,Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
| | - Junea C Oliveira
- Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
| | - Cristiano P Souza
- Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
| | - Carlos E Andrade
- Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
| | - Luis G C Romagnolo
- Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
| | - Sahlua Volc
- Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
| | - Maximiliano C Neto
- Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
| | - Cristina Sabato
- Centro de Pesquisa em Oncologia Molecular, Hospital de Câncer de Barretos, Barretos, SP, Brazil.,Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
| | - Rebeca Grasel
- Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
| | - Edmundo Mauad
- Centro de Pesquisa em Oncologia Molecular, Hospital de Câncer de Barretos, Barretos, SP, Brazil.,Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
| | - Rui M Reis
- Centro de Pesquisa em Oncologia Molecular, Hospital de Câncer de Barretos, Barretos, SP, Brazil.,Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil.,Life and Health Sciences Research Institute (ICVS), Health Sciences School, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Rodrigo A D Michelli
- Departamento de Oncogenética, Hospital de Câncer de Barretos, Barretos, SP, Brazil
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6
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Ashton-Prolla P, Seuanez HN. The Brazilian Hereditary Cancer Network: historical aspects and challenges for clinical cancer genetics in the public health care system in Brazil. Genet Mol Biol 2016; 39:163-5. [PMID: 27275665 PMCID: PMC4910555 DOI: 10.1590/1678-4685-gmb-2014-0373] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Patricia Ashton-Prolla
- Departamento de Genética, Universidade Federal do Rio Grande do Sul and Serviços de Pesquisa Experimental e Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Hector N Seuanez
- Departamento de Genética, Universidade Federal do Rio de Janeiro and Divisão de Genética, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil
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7
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Campacci N, de Lima JO, Ramadan L, Palmero EI. Knowledge about hereditary cancer of women with family histories of breast, colorectal, or both types of cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:167-172. [PMID: 24792524 DOI: 10.1007/s13187-014-0663-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Usually, the mass media do not address hereditary cancer and their risk factors, nor are these topics discussed at the community level. We used an informative guide on cancer and hereditary cancer, followed by a questionnaire on these topics to investigate the relevant knowledge among women at high risk for hereditary breast and/or colorectal cancer from a population-based cohort. The cohort was composed of 81 Brazilian women with positive family histories of breast and/or colorectal cancer. Strauss and Corbin's Grounded Theory was used for qualitative analysis. The average age of the cohort was 49.9 years old. Three participants (3.9%) were illiterate, 45 (59.2%) had attended elementary school, 14 (18.4%) had secondary school, and 14 (18.4%) held higher education degrees. A total of 47 (54.3%) volunteers were unable to fully understand the information provided in the guide because they did not know the meaning of words such as metastasis, malignant, hereditary, sporadic, or oncogenetics. Notwithstanding, the acceptance of the educational tool utilized was satisfactory, and it enhanced the volunteers' interest in a better understanding of cancer and heredity. Thereby, we concluded that the low knowledge of this important subject and the unawareness about fundamental terms required for the comprehension of this specific type of neoplasm made us believe that the use of the informative guide can provide a great value when used previously to the genetic counseling consultations. Besides, educational tools of easy understanding should be part of everyday clinical practice, from primary to specialized patient care.
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Affiliation(s)
- N Campacci
- Molecular Oncology Research Center, Barretos Cancer Hospital, Av Antenor Duarte Vilela, 1331, Barretos, São Paulo, Brazil
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Palmero EI, Caleffi M, Schüler-Faccini L, Roth FL, Kalakun L, Netto CBO, Skonieski G, Giacomazzi J, Weber B, Giugliani R, Camey SA, Ashton-Prolla P. Population prevalence of hereditary breast cancer phenotypes and implementation of a genetic cancer risk assessment program in southern Brazil. Genet Mol Biol 2009; 32:447-55. [PMID: 21637504 PMCID: PMC3036062 DOI: 10.1590/s1415-47572009005000058] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Accepted: 12/02/2008] [Indexed: 11/22/2022] Open
Abstract
In 2004, a population-based cohort (the Núcleo Mama Porto Alegre - NMPOA Cohort) was started in Porto Alegre, southern Brazil and within that cohort, a hereditary breast cancer study was initiated, aiming to determine the prevalence of hereditary breast cancer phenotypes and evaluate acceptance of a genetic cancer risk assessment (GCRA) program. Women from that cohort who reported a positive family history of cancer were referred to GCRA. Of the 9218 women enrolled, 1286 (13.9%) reported a family history of cancer. Of the 902 women who attended GCRA, 55 (8%) had an estimated lifetime risk of breast cancer ≥ 20% and 214 (23.7%) had pedigrees suggestive of a breast cancer predisposition syndrome; an unexpectedly high number of these fulfilled criteria for Li-Fraumeni-like syndrome (122 families, 66.7%). The overall prevalence of a hereditary breast cancer phenotype was 6.2% (95%CI: 5.67-6.65). These findings identified a problem of significant magnitude in the region and indicate that genetic cancer risk evaluation should be undertaken in a considerable proportion of the women from this community. The large proportion of women who attended GCRA (72.3%) indicates that the program was well-accepted by the community, regardless of the potential cultural, economic and social barriers.
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Affiliation(s)
- Edenir I. Palmero
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, RSBrazil
| | - Maira Caleffi
- Núcleo Mama Porto Alegre and Associação Hospitalar Moinhos de Vento, Porto Alegre, RSBrazil
| | - Lavínia Schüler-Faccini
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, RSBrazil
| | - Fernanda L. Roth
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RSBrazil
| | - Luciane Kalakun
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RSBrazil
| | | | - Giovana Skonieski
- Núcleo Mama Porto Alegre and Associação Hospitalar Moinhos de Vento, Porto Alegre, RSBrazil
| | - Juliana Giacomazzi
- Laboratório de Medicina Genômica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RSBrazil
| | - Bernadete Weber
- Núcleo Mama Porto Alegre and Associação Hospitalar Moinhos de Vento, Porto Alegre, RSBrazil
| | - Roberto Giugliani
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, RSBrazil
| | - Suzi A. Camey
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RSBrazil
| | - Patricia Ashton-Prolla
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, RSBrazil
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9
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Somers TJ, Michael JC, Klein WMP, Baum A. Cancer genetics service interest in women with a limited family history of breast cancer. J Genet Couns 2009; 18:339-49. [PMID: 19440660 DOI: 10.1007/s10897-009-9224-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Accepted: 01/21/2009] [Indexed: 01/09/2023]
Abstract
Women with a limited family history of breast cancer may be interested in cancer genetics information although their objective risk of breast cancer may not indicate routine referral to cancer genetics services. This study examined factors related to interest and use of cancer genetics services in a community sample of women with a limited family history of breast cancer (N = 187) who had no previous contact with cancer genetics services. Participants provided demographic information and ratings of perceived risk, cancer distress, attitudes, and intentions to initiate cancer genetics services. Participants were given information about a cancer genetics clinic that served women having concerns about their breast cancer risk. Women were contacted within 6 weeks and 8 months following their study appointment. Six weeks following their study appointment, 25% of women had initiated cancer genetics services. Eight months following their study appointment, 18% of women reported having completed a cancer genetics service appointment. Baseline intentions independently predicted both initiation at 6 weeks and appointment at 8 months. Cancer distress was positively associated with cancer genetics service initiation and appointment. Results suggest that some women with a limited family history of breast cancer are interested in seeking out cancer genetics information. Women with a limited family history of breast cancer may benefit from the availability of cancer genetics information provided through primary healthcare settings.
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Affiliation(s)
- Tamara J Somers
- Department of Psychiatry and Behavioral Science, Duke University Medical Center, Durham, NC, USA.
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