Abstract
In a sample of individuals with ovarian cancer, we aimed to (a) identify factors associated with the psychosocial impact of genetic counseling and multigene panel testing, (b) identify factors associated with cancer genetics knowledge, and (c) summarize patient-reported recommendations to improve the genetic counseling and multigene panel testing process. Eligible participants in this secondary analysis of quantitative and qualitative survey data were English-speaking adults with ovarian cancer. Psychosocial impact was assessed using the Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire. Knowledge of cancer genetics was assessed using the KnowGene scale. Significant predictors of MICRA and KnowGene scores were identified using multiple regression. Open-ended survey item responses were analyzed using conventional content analysis. Eighty-seven participants met eligibility criteria. A positive genetic test result was associated with greater adverse psychosocial impact (B = 1.13, p = 0.002). Older age (B = − 0.07, p = 0.044) and being a member of a minority racial or ethnic group (B = − 3.075, p = 0.033) were associated with lower knowledge, while a personal history of at least one other type of cancer (B = 1.975, p = 0.015) was associated with higher knowledge. In open-ended item responses, participants wanted clinicians to assist with family communication, improve result disclosure, and enhance patient and family understanding of results. A subset of individuals with ovarian cancer who receive a positive genetic test result may be at risk for adverse psychosocial outcomes. Tailored cancer genetics education is necessary to promote the equitable uptake of targeted ovarian cancer treatment and risk-reducing therapies. Interventions to enhance patient-clinician communication in this setting are a research priority.
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Acknowledgements
The authors wish to acknowledge the Center for Cancer Genetics and Prevention and the Phyllis F. Cantor Center for Research in Nursing and Patient Care Services at Dana-Farber Cancer Institute for providing clinical and research support.
Funding
Rachel A. Pozzar is supported by an American Cancer Society Postdoctoral Fellowship (133063-PF-19–102-01-CPPB) and a Society for Medical Decision Making/Gordon and Betty Moore Foundation Fellowship in Medical Decision Making (GBMF7853). Funding for the parent study was provided by the Friends of Dana-Farber. The funding sources were not involved in the study design; data collection, analysis, and interpretation; manuscript preparation; or decision to submit the paper for publication.
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RAP: Conceptualization, analysis, writing—original draft. FH: Analysis, writing—review and editing. NX: Analysis, writing—review and editing. JES: Conceptualization, writing—review and editing. MMN: Investigation, analysis, writing—review and editing. MU-B: Conceptualization, investigation, analysis, writing—review and editing.
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Jill E. Stopfer reports personal fees from Astra Zeneca. Rachel A. Pozzar, Fangxin Hong, Niya Xiong, Manan M. Nayak, and Meghan Underhill-Blazey have no conflict of interest to disclose.
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Pozzar, R.A., Hong, F., Xiong, N. et al. Knowledge and psychosocial impact of genetic counseling and multigene panel testing among individuals with ovarian cancer. Familial Cancer 21, 35–47 (2022). https://doi.org/10.1007/s10689-021-00240-6
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DOI: https://doi.org/10.1007/s10689-021-00240-6