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.
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.
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.
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.
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.
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.
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.
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.
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.
Brondum-Nielsen, K. (2003). Genetic counseling and genetic services. Ugeskrift for Laeger, 165, 777–779.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209–218.
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.
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.
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.
Kent, H. (1999). Waiting list grows for BC’s hereditary cancer program. CMAJ, 161, 1175.
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.
Knudsen, L. B. (1998). The Danish fertility database. Danish Medical Bulletin, 45, 221–225.
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.
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.
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.
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.
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.
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.
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.
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.
Munk-Jorgensen, P., & Mortensen, P. B. (1997). The Danish Psychiatric Central Register. Danish Medical Bulletin, 44, 82–84.
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.
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.
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.
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.
Sundin, E. C., & Horowitz, M. J. (2002). Impact of Event Scale: psychometric properties. British Journal of Psychiatry, 180, 205–209.
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.
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.
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.
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.
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.
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.
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.
Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.
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
Corresponding author
Rights 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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10897-007-9139-7