Article

Familial Cancer

, Volume 10, Issue 3, pp 549-556

First online:

Attitudes toward childbearing and prenatal testing in individuals undergoing genetic testing for Lynch Syndrome

  • Akriti DewanwalaAffiliated withDivision of Population Sciences, Dana-Farber Cancer Institute
  • , Anu ChittendenAffiliated withDivision of Population Sciences, Dana-Farber Cancer Institute
  • , Margery RosenblattAffiliated withDivision of Population Sciences, Dana-Farber Cancer Institute
  • , Rowena MercadoAffiliated withDivision of Population Sciences, Dana-Farber Cancer Institute
  • , Judy E. GarberAffiliated withDivision of Population Sciences, Dana-Farber Cancer InstituteDepartment of Adult Oncology, Dana-Farber Cancer InstituteHarvard Medical School
  • , Sapna SyngalAffiliated withDivision of Population Sciences, Dana-Farber Cancer InstituteHarvard Medical SchoolDivision of Gastroenterology, Brigham and Women’s Hospital
  • , Elena M. StoffelAffiliated withDivision of Population Sciences, Dana-Farber Cancer InstituteHarvard Medical SchoolDivision of Gastroenterology, Brigham and Women’s Hospital Email author 

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Abstract

To examine attitudes toward childbearing and prenatal genetic testing among individuals at risk for Lynch Syndrome (LS), the most common type of hereditary colorectal cancer. Individuals undergoing clinical genetic testing for mismatch repair (MMR) gene mutations completed written questionnaires before and after testing. 161 of 192 (84%) eligible individuals participated in the study. Mean age was 46 years (range 20–75), 71% were female, 53% had a personal diagnosis of cancer, and 68% had children. Eighty percent worried about their children’s risk for developing cancer; however only 9% reported their decision to have children was affected by their family history of cancer. When asked whether providing prenatal testing to carriers of MMR gene mutations was ethical, 66% (86/130) of respondents agreed/strongly agreed, 25% (32) were neutral and 9% (12) disagreed/strongly disagreed. Of 48 individuals planning to have children in the future, 57% (27) intended to have children regardless of their genetic test result. If found to carry a MMR gene mutation that confirmed LS, 42% (20) would consider prenatal testing for a future pregnancy and 20% (7/35) of women would consider having children earlier in order to have prophylactic surgery to reduce their risk for gynecologic cancers. Individuals undergoing genetic testing for LS may utilize test results to make reproductive decisions. Clinicians should be prepared to discuss options of reproductive genetic technologies during counseling of LS patients of childbearing age.

Keywords

Lynch syndrome Prenatal testing Preimplantation genetic diagnosis Family Genetic testing Genetic counseling