Predictors of risk-reducing surgery intentions following genetic counseling for hereditary breast and ovarian cancer.

Autor:	Ladd MK; Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.; Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, Washington, DC., Peshkin BN; Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.; Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, Washington, DC., Senter L; Division of Human Genetics, Department of Internal Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, OH., Baldinger S; Virgina Piper Cancer Institute, Allina Health, Minneapolis, MN., Isaacs C; Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.; Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, Washington, DC., Segal H; Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.; Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, Washington, DC., Philip S; Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.; Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, Washington, DC., Phillips C; Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.; Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, Washington, DC., Shane K; Division of Human Genetics, Department of Internal Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, OH., Martin A; Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.; Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, Washington, DC., Weinstein V; Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.; Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, Washington, DC., Pilarski R; Division of Human Genetics, Department of Internal Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, OH., Jeter J; Division of Human Genetics, Department of Internal Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, OH., Sweet K; Division of Human Genetics, Department of Internal Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, OH., Hatten B; Virgina Piper Cancer Institute, Allina Health, Minneapolis, MN., Wurtmann EJ; Virgina Piper Cancer Institute, Allina Health, Minneapolis, MN., Phippen S; Virgina Piper Cancer Institute, Allina Health, Minneapolis, MN., Bro D; Virgina Piper Cancer Institute, Allina Health, Minneapolis, MN., Schwartz MD; Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.; Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, Washington, DC.
Jazyk:	angličtina
Zdroj:	Translational behavioral medicine [Transl Behav Med] 2020 May 20; Vol. 10 (2), pp. 337-346.
DOI:	10.1093/tbm/iby101
Abstrakt:	Risk-reducing mastectomy (RRM) and salpingo-oophorectomy (RRSO) are increasingly used to reduce breast and ovarian cancer risk following BRCA1/BRCA2 testing. However, little is known about how genetic counseling influences decisions about these surgeries. Although previous studies have examined intentions prior to counseling, few have examined RRM and RRSO intentions in the critical window between genetic counseling and test result disclosure. Previous research has indicated that intentions at this time point predict subsequent uptake of surgery, suggesting that much decision-making has taken place prior to result disclosure. This period may be a critical time to better understand the drivers of prophylactic surgery intentions. The aim of this study was to examine predictors of RRM and RRSO intentions. We hypothesized that variables from the Health Belief Model would predict intentions, and we also examined the role of affective factors. Participants were 187 women, age 21-75, who received genetic counseling for hereditary breast and ovarian cancer. We utilized multiple logistic regression to identify independent predictors of intentions. 49.2% and 61.3% of participants reported intentions for RRM and RRSO, respectively. Variables associated with RRM intentions include: newly diagnosed with breast cancer (OR = 3.63, 95% CI = 1.20-11.04), perceived breast cancer risk (OR = 1.46, 95% CI = 1.17-1.81), perceived pros (OR = 1.79, 95% CI = 1.38-2.32) and cons of RRM (OR = 0.81, 95% CI = 0.65-0.996), and decision conflict (OR = 0.80, 95% CI = 0.66-0.98). Variables associated with RRSO intentions include: proband status (OR = 0.28, 95% CI = 0.09-0.89), perceived pros (OR = 1.35, 95% CI = 1.11-1.63) and cons of RRSO (OR = 0.72, 95% CI = 0.59-0.89), and ambiguity aversion (OR = 0.79, 95% CI = 0.65-0.95). These data provide support for the role of genetic counseling in fostering informed decisions about risk management, and suggest that the role of uncertainty should be explored further. (© Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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