Article

Familial Cancer

, Volume 10, Issue 2, pp 213-223

First online:

BRCA1/2 genetic testing uptake and psychosocial outcomes in men

  • Kristi D. GravesAffiliated withCancer Control Program, Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown UniversityFisher Center for Familial Cancer Research, Lombardi Comprehensive Cancer Center, Georgetown University Email author 
  • , Rhoda GatammahAffiliated withUniversity of the District of Columbia
  • , Beth N. PeshkinAffiliated withCancer Control Program, Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown UniversityFisher Center for Familial Cancer Research, Lombardi Comprehensive Cancer Center, Georgetown University
  • , Ayelet KriegerAffiliated withCancer Control Program, Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown UniversityFisher Center for Familial Cancer Research, Lombardi Comprehensive Cancer Center, Georgetown University
  • , Christy GellAffiliated withCancer Control Program, Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University
  • , Heiddis B. ValdimarsdottirAffiliated withMount Sinai School of MedicineDepartment of Health and Education, Reykjavik University
  • , Marc D. SchwartzAffiliated withCancer Control Program, Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown UniversityFisher Center for Familial Cancer Research, Lombardi Comprehensive Cancer Center, Georgetown University

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Abstract

Few studies have quantitatively evaluated the uptake and outcomes of BRCA1/2 genetic counseling and testing in men. We conducted a prospective longitudinal study to describe and compare uptake of and psychosocial outcomes following BRCA1/2 testing in a sample of men and women at high-risk for carrying a BRCA1/2 mutation. Men (n = 98) and women (n = 243) unaffected with cancer completed baseline assessments prior to genetic counseling and testing and then 6- and 12-months post-testing. Most men (n = 94; 95.9%) opted to have genetic testing, of whom 44 received positive BRCA1/2 genetic test results and 50 received true negative results. Among women, 93.4% had genetic testing, of whom 79 received positive results and 148 received negative results. In multivariate models, male BRCA1/2 carriers reported significantly higher genetic testing distress (6-months: Z = 4.48, P < 0.0001; 12-months: Z = 2.78, P < 0.01) than male non-carriers. After controlling for baseline levels of distress, no statistically significant differences emerged between male and female BRCA1/2 carriers in psychological distress at 12-months post-testing, although absolute differences were evident over time. Predictors of distress related to genetic testing among male carriers at 12-months included higher baseline cancer-specific distress (Z = 4.73, P < 0.0001) and being unmarried (Z = 2.18, P < 0.05). Similarly, baseline cancer-specific distress was independently associated with cancer-specific distress at 6- (Z = 3.66, P < 0.001) and 12-months (Z = 4.44, P < 0.0001) post-testing among male carriers. Clinically, our results suggest that pre-test assessment of distress and creation of educational materials specifically tailored to the needs and concerns of male carriers may be appropriate in this important but understudied high-risk group.

Keywords

BRCA1/2 Cancer risk Genetic testing Male female comparisons Men Psychosocial outcomes Test uptake