No abstract

Hereditary cancer syndromes are inherited pathogenic genetic variants that significantly increase the risk of developing cancer. When individuals become aware of their increased probability of having cancer, the whole family is affected by this new reality and needs to adjust. However, adjustment to hereditary cancer syndromes has been mainly studied at an individual level, and research about familial adjustment remains dispersed and disorganized. To overcome this gap, this review aims to understand how families adjust to genetic testing and risk management, and to what extent the family’s adjustment influences the psychological response and risk management behaviors of mutation carriers. We conducted searches on the PubMed/Med Line, PsycInfo, SCOPUS, and Google Scholar databases and used the Mixed Methods Appraisal Tool (MMAT-v2018) to assess the methodological quality of each selected study. Thirty studies met the inclusion criteria. Most results highlighted the interdependent nature of adjustment of pathogenic variant carriers and their families. The way carriers adjust to the syndrome is highly related to how family members react, particularly partners and siblings dependent on prior family functioning. Couples who share their worries and communicate openly about cancer risk present a better long-term adjustment than couples who use protective buffering (not talking about it to avoid disturbing the partner) or emotional distancing. Parents need help dealing with disclosing genetic information to their children. These findings reinforce the importance of adopting a family-centered approach in the context of genetic counseling and the necessity of involving family members in research.

Benavente (Portugal) is a small town which, compared to the rest of the country, has higher levels of the following three types of risks: earthquakes (natural risk), criminality (social risk) and the running of the bulls (cultural risk). This has allowed us to explore spatial bias, i.e., whether people have lower perceptions of risk at the local level than at the national or international levels, or if there are any risks strongly related with the local culture that show a different pattern. We also test whether risk perception dimensions identified by a psychometric paradigm relate to the three risk types that are highly prevalent in Benavente. The results support the spatial bias in relation to earthquakes and criminality but reveal a reverse pattern regarding the running of the bulls (cultural risk). The results also showed that people scored higher on the Dread dimension for earthquakes, followed by criminality, with lower scores in regard to the running of the bulls. The opposite was verified regarding the Control dimension.