Skip to main content
Log in

Psychosocial Conditions of Women Awaiting Genetic Counseling: A Population-based Study

  • Original Research
  • Published:
Journal of Genetic Counseling

Abstract

The decision whether to undergo genetic counseling for hereditary breast and ovarian cancer is complex. Knowledge about the psychosocial conditions of women who are awaiting counseling is sparse. We aimed to compare the psychosocial conditions of women awaiting genetic counseling with those of women in two reference groups. We included 567 women referred to genetic counseling for hereditary risk of breast or ovarian cancer (Genetic Group), 689 women referred to mammography (Mammography Group) and a random sample of 2,000 women from the general population (Population Group). One to 4 weeks before the first counseling session or mammography, data were collected by questionnaires. Both women affected with cancer and unaffected women in the Genetic Group appeared to have a somewhat higher prevalence of cancer-specific-distress than the corresponding reference groups. Further research on the effect of pre- counseling interventions appear warranted in addition with exploring a potential association between waiting time and cancer-specific distress.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Andersen, T. F., Madsen, M., Jorgensen, J., Mellemkjoer, L., & Olsen, J. H. (1999). The Danish National Hospital Register. A valuable source of data for modern health sciences. Danish Medical Bulletin, 46, 263–268.

    PubMed  CAS  Google Scholar 

  • Bish, A., Sutton, S., Jacobs, C., Levene, S., Ramirez, A., & Hodgson, S. (2002). Changes in psychological distress after cancer genetic counselling: A comparison of affected and unaffected women. British Journal of Cancer, 86, 43–50.

    Article  PubMed  CAS  Google Scholar 

  • Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research, 52, 69–77.

    Article  PubMed  Google Scholar 

  • Bjorner, J. B., Damsgaard, M. T., Watt, T., Bech, P., Rasmussen, N. K., Kristensen, T. S., et al. (1997). Dansk manual til SF-36. Copenhagen: Lif.

    Google Scholar 

  • Bowen, D. J., Burke, W., McTiernan, A., Yasui, Y., & Andersen, M. R. (2004). Breast cancer risk counseling improves women’s functioning. Patient Education and Counseling, 53, 79–86.

    Article  PubMed  Google Scholar 

  • Brain, K., Gray, J., Norman, P., France, E., Anglim, C., Barton, G., et al. (2000a). Randomized trial of a specialist genetic assessment service for familial breast cancer. Journal of the National Cancer Institute, 92, 1345–1351.

    Article  PubMed  CAS  Google Scholar 

  • Brain, K., Gray, J., Norman, P., Parsons, E., Clarke, A., Rogers, C., et al. (2000b). Why do women attend familial breast cancer clinics. Journal of Medical Genetics, 37, 197–202.

    Article  PubMed  CAS  Google Scholar 

  • Braithwaite, D., Emery, J., Walter, F., Prevost, A. T., & Sutton, S. (2004). Psychological impact of genetic counseling for familial cancer: a systematic review and meta-analysis. Journal of the National Cancer Institute, 96, 122–133.

    Article  PubMed  Google Scholar 

  • Brondum-Nielsen, K. (2003). Genetic counseling and genetic services. Ugeskrift for Laeger, 165, 777–779.

    PubMed  Google Scholar 

  • Calzone, K. A., Prindiville, S. A., Jourkiv, O., Jenkins, J., DeCarvalho, M., Wallerstedt, D. B., et al. (2005). Randomized comparison of group versus individual genetic education and counseling for familial breast and/or ovarian cancer. Journal of Clinical Oncology, 23, 3455–3464.

    Article  PubMed  Google Scholar 

  • Carlsson, A. H., Bjorvatn, C., Engebretsen, L. F., Berglund, G., & Natvig, G. K. (2004). Psychosocial factors associated with quality of life among individuals attending genetic counseling for hereditary cancer. Journal of Genetic Counseling, 13, 425–445.

    Article  PubMed  Google Scholar 

  • Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases, 40, 373–383.

    Article  PubMed  CAS  Google Scholar 

  • Claus, E. B., Schildkraut, J. M., Thompson, W. D., & Risch, N. J. (1996). The genetic attributable risk of breast and ovarian cancer. Cancer, 77, 2318–2324.

    Article  PubMed  CAS  Google Scholar 

  • Cull, A., Anderson, E. D., Campbell, S., Mackay, J., Smyth, E., & Steel, M. (1999). The impact of genetic counselling about breast cancer risk on women’s risk perceptions and levels of distress. British Journal of Cancer, 79, 501–508.

    Article  PubMed  CAS  Google Scholar 

  • Cull, A., Fry, A., Rush, R., & Steel, C. M. (2001). Cancer risk perceptions and distress among women attending a familial ovarian cancer clinic. British Journal of Cancer, 84, 594–599.

    Article  PubMed  CAS  Google Scholar 

  • Cull, A., Miller, H., Porterfield, T., Mackay, J., Anderson, E. D., Steel, C. M., et al. (1998). The use of videotaped information in cancer genetic counselling: A randomized evaluation study. British Journal of Cancer, 77, 830–837.

    PubMed  CAS  Google Scholar 

  • Ford, D., Easton, D. F., Stratton, M., Narod, S., Goldgar, D., Devilee, P., et al. (1998). Genetic heterogeneity and penetrance analysis of the BRCA1 and BRCA2 genes in breast cancer families. The Breast Cancer Linkage Consortium. American Journal of Human Genetics, 62, 676–689.

    Article  PubMed  CAS  Google Scholar 

  • Fry, A., Cull, A., Appleton, S., Rush, R., Holloway, S., Gorman, D., et al. (2003). A randomised controlled trial of breast cancer genetics services in South East Scotland: Psychological impact. British Journal of Cancer, 89, 653–659.

    Article  PubMed  CAS  Google Scholar 

  • Hallowell, N., Murton, F., Statham, H., Green, J. M., & Richards, M. P. (1997). Women’s need for information before attending genetic counselling for familial breast or ovarian cancer: a questionnaire, interview, and observational study. BMJ, 314, 281–283.

    PubMed  CAS  Google Scholar 

  • Hopwood, P., Wonderling, D., Watson, M., Cull, A., Douglas, F., Cole, T., et al. (2004). A randomised comparison of UK genetic risk counselling services for familial cancer: Psychosocial outcomes. British Journal of Cancer, 91, 884–892.

    PubMed  CAS  Google Scholar 

  • Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209–218.

    PubMed  CAS  Google Scholar 

  • Humphreys, L., Hunter, A. G., Zimak, A., O’Brien, A., Korneluk, Y., & Cappelli, M. (2000). Why patients do not attend for their appointments at a genetics clinic. Journal of Medical Genetics, 37, 810–815.

    Article  PubMed  CAS  Google Scholar 

  • Jorgensen, C. K., & Karlsmose, B. (1998). Validation of automated forms processing. A comparison of Teleform with manual data entry. Computers in Biology Medicine, 28, 659–667.

    Article  CAS  Google Scholar 

  • Kasparian, N. A., Wakefield, C. E., & Meiser, B. (2007). Assessment of psychosocial outcomes in genetic counseling research an overview of available measurement scales. Journal of Genetic Counseling, 6, 693–712.

    Article  Google Scholar 

  • Kent, H. (1999). Waiting list grows for BC’s hereditary cancer program. CMAJ, 161, 1175.

    PubMed  CAS  Google Scholar 

  • Kinmonth, A. L., Reinhard, J., Bobrow, M., & Pauker, S. (1998). The new genetics. Implications for clinical services in Britain and the United States. BMJ, 316, 767–770.

    PubMed  CAS  Google Scholar 

  • Knudsen, L. B. (1998). The Danish fertility database. Danish Medical Bulletin, 45, 221–225.

    PubMed  CAS  Google Scholar 

  • Lerman, C., Daly, M., Masny, A., & Balshem, A. (1994). Attitudes about genetic testing for breast-ovarian cancer susceptibility. Journal of Clinical Oncology, 12, 843–850.

    PubMed  CAS  Google Scholar 

  • Lerman, C., Schwartz, M. D., Miller, S. M., Daly, M., Sands, C., & Rimer, B. K. (1996). A randomized trial of breast cancer risk counseling: interacting effects of counseling, educational level, and coping style. Health Psychology, 15, 75–83.

    Article  PubMed  CAS  Google Scholar 

  • Lerman, C., Seay, J., Balshem, A., & Audrain, J. (1995). Interest in genetic testing among first-degree relatives of breast cancer patients. American Journal of Medical Genetics, 57, 385–392.

    Article  PubMed  CAS  Google Scholar 

  • Lobb, E. A., Butow, P. N., Meiser, B., Barratt, A., Gaff, C., Young, M. A., et al. (2002). Tailoring communication in consultations with women from high risk breast cancer families. British Journal of Cancer, 87, 502–508.

    Article  PubMed  CAS  Google Scholar 

  • Meiser, B., Butow, P. N., Barratt, A. L., Schnieden, V., Gattas, M., Kirk, J., et al. (2001). Long-term outcomes of genetic counseling in women at increased risk of developing hereditary breast cancer. Patient Education and Counseling, 44, 215–225.

    Article  PubMed  CAS  Google Scholar 

  • Meiser, B., & Halliday, J. L. (2002). What is the impact of genetic counselling in women at increased risk of developing hereditary breast cancer? A meta-analytic review. Social Science & Medicine, 54, 1463–1470.

    Article  Google Scholar 

  • Miki, Y., Swensen, J., Shattuck-Eidens, D., Futreal, P. A., Harshman, K., Tavtigian, S., et al. (1994). A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science, 266, 66–71.

    Article  PubMed  CAS  Google Scholar 

  • Mogilner, A., Otten, M., Cunningham, J. D., & Brower, S. T. (1998). Awareness and attitudes concerning BRCA gene testing. Annals of Surgical Oncology, 5, 607–612.

    Article  PubMed  CAS  Google Scholar 

  • Munk-Jorgensen, P., & Mortensen, P. B. (1997). The Danish Psychiatric Central Register. Danish Medical Bulletin, 44, 82–84.

    PubMed  CAS  Google Scholar 

  • Randall, J., Butow, P., Kirk, J., & Tucker, K. (2001). Psychological impact of genetic counselling and testing in women previously diagnosed with breast cancer. Internal Medicine Journal, 31, 397–405.

    Article  PubMed  CAS  Google Scholar 

  • Rose, M. S., Koshman, M. L., Spreng, S., & Sheldon, R. (1999). Statistical issues encountered in the comparison of health-related quality of life in diseased patients to published general population norms: problems and solutions. Journal of Clinical Epidemiology, 52, 405–412.

    Article  PubMed  CAS  Google Scholar 

  • Schwartz, M. D., Peshkin, B. N., Hughes, C., Main, D., Isaacs, C., & Lerman, C. (2002). Impact of BRCA1/BRCA2 mutation testing on psychologic distress in a clinic-based sample. Journal of Clinical Oncology, 20, 514–520.

    Article  PubMed  Google Scholar 

  • Storm, H. H., Michelsen, E. V., Clemmensen, I. H., & Pihl, J. (1997). The Danish Cancer Registry-history, content, quality and use. Danish Medical Bulletin, 44, 535–539.

    PubMed  CAS  Google Scholar 

  • Sundin, E. C., & Horowitz, M. J. (2002). Impact of Event Scale: psychometric properties. British Journal of Psychiatry, 180, 205–209.

    Article  PubMed  Google Scholar 

  • Thorlacius, S., Struewing, J. P., Hartge, P., Olafsdottir, G. H., Sigvaldason, H., Tryggvadottir, L., et al. (1998). Population-based study of risk of breast cancer in carriers of BRCA2 mutation. Lancet, 352, 1337–1339.

    Article  PubMed  CAS  Google Scholar 

  • Van Asperen, C. J., Van Dijk, S., Zoeteweij, M. W., Timmermans, D. R., De Bock, G. H., Meijers-Heijboer, E. J., et al. (2002). What do women really want to know? Motives for attending familial breast cancer clinics. Journal of Medical Genetics, 39, 410–414.

    Article  PubMed  Google Scholar 

  • Ware Jr., J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473–483.

    Article  PubMed  Google Scholar 

  • Watson, M., Lloyd, S., Davidson, J., Meyer, L., Eeles, R., Ebbs, S., et al. (1999). The impact of genetic counselling on risk perception and mental health in women with a family history of breast cancer. British Journal of Cancer, 79, 868–874.

    Article  PubMed  CAS  Google Scholar 

  • Wonderling, D., Hopwood, P., Cull, A., Douglas, F., Watson, M., Burn, J., et al. (2001). A descriptive study of UK cancer genetics services: an emerging clinical response to the new genetics. British Journal of Cancer, 85, 166–170.

    Article  PubMed  CAS  Google Scholar 

  • Wood, M. E., Mullineaux, L., Rahm, A. K., Fairclough, D., & Wenzel, L. (2000). Impact of BRCA1 testing on women with cancer: a pilot study. Genetic Testing, 4, 265–272.

    Article  PubMed  CAS  Google Scholar 

  • Wooster, R., Neuhausen, S. L., Mangion, J., Quirk, Y., Ford, D., Collins, N., et al. (1994). Localization of a breast cancer susceptibility gene, BRCA2, to chromosome 13q12–13. Science, 265, 2088–2090.

    Article  PubMed  CAS  Google Scholar 

  • Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

We thank the patients for participating, the hospital staffs for coordinating patient enrollment and Henrik F. Thomsen, biostatistician at the Department of Clinical Epidemiology, Aarhus University Hospital, for assistance with statistical analyses of register-data.

The research was funded by the Danish Cancer Society Grant Number PP 02 010, the Center of Innovation and Development in Nursing Education in the County of Aarhus, and Aarhus University Research Foundation.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ellen M. Mikkelsen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mikkelsen, E.M., Sunde, L., Johansen, C. et al. Psychosocial Conditions of Women Awaiting Genetic Counseling: A Population-based Study. J Genet Counsel 17, 242–251 (2008). https://doi.org/10.1007/s10897-007-9139-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10897-007-9139-7

Keywords

Navigation