Effects of coping style and BRCA1 and BRCA2 test results on anxiety among women participating in genetic counseling and testing for breast and ovarian cancer risk.
ABSTRACT Using the monitoring process model (MPM), the authors examined the immediate effects of coping style and test results on the psychological distress of women at increased risk for breast and/or ovarian cancers. Cases selected for analysis were 107 probands and relatives of positive probands participating in genetic counseling and testing for heritable cancer risk. Specifically, the authors explored the relationships among coping style (high and low monitoring), test results (BRCA1 and BRCA2 mutation carrier and noncarrier status), and psychological distress (state anxiety). Consistent with the MPM, higher monitoring was associated with greater psychological distress while anticipating genetic test results. After test results were disclosed, greater distress was associated with testing positive for a mutation. The implications of the findings for breast and ovarian cancer patients are discussed.
Article: Predictors of choosing life-long screening or prophylactic surgery in women at high and moderate risk for breast and ovarian cancer.[show abstract] [hide abstract]
ABSTRACT: The aim of this study is to summarize published empirical data describing the predictors of adhering to screening practices and choosing to have prophylactic surgery in women at increased risk for breast and ovarian cancer. Pubmed, Psychinfo and Cinahl databases were searched to identify studies on the predictors of adherence to breast and ovarian cancer screening and predictors of having a prophylactic mastectomy or salpingo-oophorectomy. We found 37 empirical studies that met our inclusion criteria. The main predictors of the use of preventive measures are related to DNA test results, socio-demographic characteristics, and psychological outcome measures. It is concluded that there is no unequivocal relationship between age, education, risk perception, or anxiety and adherence to breast and ovarian cancer screening practices. Worrying about cancer is associated with a higher adherence to screening practices.Familial Cancer 04/2008; 7(4):347-59. · 1.30 Impact Factor
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ABSTRACT: There is a widely held expectation that screening for disease has adverse emotional impacts. The aim of the current review is to estimate the short (< 4 weeks) and longer term (> 4 weeks) emotional impact of such screening. Studies selected for inclusion were (a) randomised controlled trials in which (b) participants in one arm underwent screening and received test results, and those in a control arm did not, and (c) emotional outcomes were assessed in both arms. MEDLINE via PubMed (1950 to present), EMBASE (1980 to present), PsycINFO (1985 to present) using OVID SP, and CINAHL (1982 to present) via EBSCO were searched, using strategies developed with keywords and medical subject headings. Data were extracted on emotional outcomes, type of screening test and test results. Of the 12 studies that met the inclusion criteria, six involved screening for cancer, two for diabetes, and one each for abdominal aortic aneurysms, peptic ulcer, coronary heart disease and osteoporosis. Five studies reported data on anxiety, five [corrected] on depression, two on general distress and eight on quality of life assessed between one week and 13 years after screening (median = 1.3 years).Meta-analyses revealed no significant impact of screening on longer term anxiety (pooled SMD 0.01, 95% CI -0.10, 0.11), depression (pooled SMD -0.04, 95% CI -.12, 0.20), or quality of life subscales (mental and self-assessed health pooled SMDs, respectively: 0.03; -0.01, (95% CI -.02, 0.04; 0.00, 95% CI -.04, 0.03). Screening does not appear to have adverse emotional impacts in the longer term (> 4 weeks). Too few studies assessed outcomes before four weeks to comment on the shorter term emotional impact of screening.BMC Public Health 07/2011; 11:603. · 2.00 Impact Factor
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ABSTRACT: ABSTRACT: After the publication of this work , we became aware that two of the twelve studies included in the review [refs 25 and 30] were erroneously described as not having presented outcomes by randomisation (ie those randomised to screening vs those randomised not to be screened). Instead they were described as having presented outcomes according to those who were randomised and who attended vs those randomised not to be screened). We have now extracted the correct data from these two studies which resulted in revised pooled Standardised Mean Differences (SMDs). None of the conclusions reached in the uncorrected version of the paper has been revised in the light of these changes. We describe here the changes arising from this error as shown in corrected form in the accompanying revised Tables 1 and 2 and Figure 2. (i) The number of participants included has now been amended to reflect the altered data extracted from studies 25 and 30, altering this from 170,045 to 170,277 participants, as shown in Table 1 and Table 2. (ii) The SMDs from the meta-analyses have been recalculated resulting in changes to the pooled SMDs now shown in Figure 2 where corrections have been made to the data for sections (a) (b) and (d). (iii) The sensitivity analyses have been redone so that studies 25 and 30, in addition to study 26, were removed to assess the impact of measurements in the primary outcome being made in all those randomised to be screened regardless of whether or not they attended (as opposed to those randomised and who attended). The inclusion of the two further studies did not alter the outcome of this sensitivity analysis, which reveals no impact on the primary outcome. In making these changes we became aware of three other errors that had not been corrected at final draft stage of the publishing process. These are described below: (iv) In the abstract, we erroneously reported the number of studies assessing depression as four. It should be five. (v) Data from  were erroneously included in pooled estimates of short term anxiety and depression by screening test outcome. (vi) The references listed as including data from attenders and non attenders in the intervention arm should now read: [25,26,27 & 30] and the reference to those including only attenders should correctly read: [24,28,29,31-35]. We regret any inconvenience that these corrections might have caused. We wish to thank Dr. Simon Griffin for bringing this matter to our attention in relation to reference 30, resulting in re-checking of all data extracted from the included studies.BMC Public Health 09/2011; 11(1):752. · 2.00 Impact Factor