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Annals of Oncology Advance Access published online on April 6, 2006
Annals of Oncology, doi:10.1093/annonc/mdl069
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© 2006 European Society for Medical Oncology
Received November 22, 2005
Revised February 23, 2006
Accepted March 1, 2006

original article

Experience of parental cancer in childhood is a risk factor for psychological distress during genetic cancer susceptibility testing

I. van Oostrom 1 *, H. Meijers-Heijboer 2, H. J. Duivenvoorden 3, A. H. J. T. Bröcker-Vriends 4, C. J. van Asperen 4, R. H. Sijmons 5, C. Seynaeve 6, A. R. Van Gool 7, J. G. M. Klijn 6, and A. Tibben 8

1 Department of Clinical Genetics, Erasmus MC; Medical Psychology and Psychotherapy, Erasmus MC
2 Department of Clinical Genetics, Erasmus MC
3 Medical Psychology and Psychotherapy, Erasmus MC
4 Center of Human and Clinical Genetics, Leiden University Medical Center
5 Department of Clinical Genetics, University Medical Center Groningen, University of Groningen, The Netherlands
6 Department of Medical Oncology, Erasmus MC - Daniel den Hoed Cancer Center, University Medical Center Rotterdam
7 Department of Psychiatry, Erasmus MC - Daniel den Hoed Cancer Center, University Medical Center Rotterdam
8 Department of Clinical Genetics, Erasmus MC; Medical Psychology and Psychotherapy, Erasmus MC; Center of Human and Clinical Genetics, Leiden University Medical Center

* To whom correspondence should be addressed.
I. van Oostrom, E-mail: i.vanoostrom{at}erasmusmc.nl


  Abstract

Background: This study explores the effect of age at the time of parental cancer diagnosis or death on psychological distress and cancer risk perception in individuals undergoing genetic testing for a specific cancer susceptibility.

Patients and methods: Cancer-related distress, worry and risk perception were assessed in 271 applicants for genetic testing of an identified mutation in BRCA1/2 (BReast CAncer) or a HNPCC (Hereditary Nonpolyposis Colorectal Cancer) related gene before, one week after, and six months after genetic test disclosure. The course of distress and risk perception were compared between individuals having witnessed parental cancer or loss due to cancer in childhood, adolescence, adulthood and having unaffected parents.

Results: Individuals with parental cancer in childhood (under age 13) reported the highest level of cancer related distress, worry and risk perception. Women having their mother affected by breast cancer in puberty (aged 10-13 years) perceived higher breast cancer risks than women with an affected mother in adulthood or without an affected mother. Individuals with an affected parent perceived cancer risks as higher than individuals without an affected parent, but were not more distressed.

Conclusions: Experience of parental cancer in childhood is a risk factor for psychological distress during the genetic testing process.

Keywords: genetic screening; family health; psychological functioning; tumour suppressor genes.
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