Familial Cancer

, Volume 10, Issue 2, pp 213–223

BRCA1/2 genetic testing uptake and psychosocial outcomes in men

  • Kristi D. Graves
  • Rhoda Gatammah
  • Beth N. Peshkin
  • Ayelet Krieger
  • Christy Gell
  • Heiddis B. Valdimarsdottir
  • Marc D. Schwartz
Article

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 

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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Kristi D. Graves
    • 1
    • 2
  • Rhoda Gatammah
    • 3
  • Beth N. Peshkin
    • 1
    • 2
  • Ayelet Krieger
    • 1
    • 2
  • Christy Gell
    • 1
  • Heiddis B. Valdimarsdottir
    • 4
    • 5
  • Marc D. Schwartz
    • 1
    • 2
  1. 1.Cancer Control Program, Department of Oncology, Lombardi Comprehensive Cancer CenterGeorgetown UniversityWashingtonUSA
  2. 2.Fisher Center for Familial Cancer Research, Lombardi Comprehensive Cancer CenterGeorgetown UniversityWashingtonUSA
  3. 3.University of the District of ColumbiaWashingtonUSA
  4. 4.Mount Sinai School of MedicineNew YorkUSA
  5. 5.Department of Health and EducationReykjavik UniversityReykjavikIceland

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