Colorectal Cancer in the Family: Psychosocial Distress and Social Issues in the Years Following Genetic Counselling

Bleiker, Menko, Kluijt Irma, Taal, Gerritsma, Wever, Aaronson

Description

This study examined: (1) levels of cancer-specific distress more than one year after genetic counselling for hereditary nonpolyposis colorectal cancer (HNPCC); (2) associations between sociodemographic, clinical and psychosocial factors and levels of distress; (3) the impact of genetic counselling on family relationships, and (4) social consequences of genetic counselling. Methods In this cross-sectional study, individuals who had received genetic counselling for HNPCC during 1986–1998 completed a self-report questionnaire by mail. Results 116 individuals (81% response rate) completed the questionnaire, on average 4 years after the last counselling session. Of all respondents, 6% had clinically significant levels of cancer-specific distress (Impact of Event Scale, IES). Having had contact with a professional psychosocial worker for cancer risk in the past 10 years was significantly associated with higher levels of current cancer specific distress. Only a minority of the counselees reported any adverse effects of genetic counselling on: communication about genetic counselling with their children (9%), family relationships (5%), obtaining life insurance (8%), choice or change of jobs (2%), and obtaining a mortgage (2%). Conclusion On average, four years after genetic counselling for HNPCC, only a small minority of counselled individuals reports clinically significant levels of distress, or significant family or social problems.

Sujets

• Colorectal cancer
• Cancer colorectal héréditaire sans polypose
• Genetic counseling

Informations

• Publié par: biomed
• Publié le: 01 janvier 2007
• Nombre de lectures: 3
• Langue: English

Extrait

Hereditary Cancer in Clinical Practice 2007; 5(2) pp. 59-66

Colorectal Cancer in the Family: Psychosocial Distress and Social Issues in the Years Following Genetic Counselling

1 2 3 4 1 1 1 Eveline M.A. Bleiker , Fred H. Menko , Irma Kluijt , Babs G. Taal , Miranda A. Gerritsma , Lidwina D.V. Wever , Neil K. Aaronson

1 Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam 2 Department of Clinical Genetics and Human Genetics, VU University Medical Center, Amsterdam 3 Department of Clinical Genetics, Academic Medical Center, Amsterdam 4 Department of Gastroenterology, The Netherlands Cancer Institute, Amsterdam

Key words: colorectal cancer, HNPCC , genetic counselling, psychosocial impact

C o r r e s p o n d i n g a u t h o r : E v e l i n e M . A . B l e i ke r, D i v i s i o n o f Ps y c h o s o c i a l Re s e a r c h a n d E p i d e m i o l o g y, N e t h e r l a n d s C a n c e r I n s t i t u t e , P l e s m a n l a a n 1 2 1 , 1 0 6 6 C X A m s t e r d a m , T h e N e t h e r l a n d s , t e l . : + 3 1 - 2 0 - 5 1 2 . 6 0 7 2 , f a x : + 3 1 - 2 0 - 5 1 2 . 2 3 2 2 , e -mail: [e-mail]

Submitted: 2 May 2007 Accepted: 22 May 2007

Abstract

Background: This study examined: (1) levels of cancer-specific distress more than one year after genetic counselling for hereditary nonpolyposis colorectal cancer (HNPCC); (2) associations between sociodemographic, clinical and psychosocial factors and levels of distress; (3) the impact of genetic counselling on family relationships, and (4) social consequences of genetic counselling. Methods: In this cross-sectional study, individuals who had received genetic counselling for HNPCC during 1986-1998 completed a self-report questionnaire by mail. Results: 116 individuals (81% response rate) completed the questionnaire, on average 4 years after the last counselling session. Of all respondents, 6% had clinically significant levels of cancer-specific distress (Impact of Event Scale, IES). Having had contact with a professional psychosocial worker for cancer risk in the past 10 years was significantly associated with higher levels of current cancer specific distress. Only a minority of the counselees reported any adverse effects of genetic counselling on: communication about genetic counselling with their children (9%), family relationships (5%), obtaining life insurance (8%), choice or change of jobs (2%), and obtaining a mortgage (2%). Conclusion: On average, four years after genetic counselling for HNPCC, only a small minority of counselled individuals reports clinically significant levels of distress, or significant family or social problems.

Introduction

Between 1 and 6% of all colorectal cancers represent a well-delineated genetic syndrome, hereditary nonpolyposis colorectal cancer (HNPCC or Lynch syndrome) [1, 2]. Before 1993, cancer risk estimates

Hereditary Cancer in Clinical Practice 2007; 5(2)

and colon screening recommendations were based on family history only [3]. Since 1993, genetic testing for HNPCC has been possible for at-risk families [4-7]. Carriers of HNPCC-related mutations have a lifetime risk of up to 80% of developing colorectal cancer [8]. Those meeting the clinical criteria for HNPCC [9] and

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