4.2 Article

Knowledge and psychosocial impact of genetic counseling and multigene panel testing among individuals with ovarian cancer

Journal

FAMILIAL CANCER
Volume 21, Issue 1, Pages 35-47

Publisher

SPRINGER
DOI: 10.1007/s10689-021-00240-6

Keywords

Neoplastic syndromes; Hereditary; Ovarian neoplasms; Genetic counseling; Genetic testing; Psychological distress; Knowledge

Funding

  1. American Cancer Society Postdoctoral Fellowship [133063-PF-19-102-01-CPPB]
  2. Society for Medical Decision Making/Gordon and Betty Moore Foundation Fellowship in Medical Decision Making [GBMF7853]
  3. Friends of Dana-Farber

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This study aimed to explore factors associated with the psychosocial impact and cancer genetics knowledge in ovarian cancer patients undergoing genetic counseling and testing. Positive genetic test results were linked to greater adverse psychosocial impacts, while older age and minority racial or ethnic group membership were associated with lower knowledge levels. Patients expressed a desire for clinicians to support family communication, improve result disclosure, and enhance understanding of results.
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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