A brief assessment of concerns associated with genetic testing for cancer: The multidimensional impact of cancer risk assessment (MICRA) questionnaire.

Cella, David; Hughes, Chanita; Peterman, Amy H.; Chang, Chih Hung; Peshkin, Beth N.; Schwartz, Marc D.; Wenzel, Lari; Lemke, Amy A.; Marcus, Alfred C.; Lerman, Caryn

doi:10.1037/0278-6133.21.6.564

Cited by 250 publications

(296 citation statements)

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“…The Genetic Psychosocial Risk Instrument (GPRI) 125 is a validated, brief, and reliable 20-item instrument that screens for psychological risk among adults who are undergoing genetic testing for cancer and other adultonset hereditary diseases, but it is not specific to cancer. Three other instruments, the MICRA questionnaire, 92 the Genetic Risk Assessment Coping Evaluation (GRACE), 126 and the Psychosocial Aspects of Hereditary Cancer (PAHC) questionnaire, 127 more specific to the process of cancer genetic testing, as described in more detail below.…”

Section: Discussionmentioning

confidence: 99%

“…51 However, in some studies, an increase was observed in long-term distress among BRCA1/BRCA2 carriers. A 5-year prospective study by Graves et al demonstrated that women who were BRCA1/BRCA2 carriers reported greater genetic testing distress 91 measured according to the Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire 92 regardless of their cancer status. The impact of the testing results on distress remained statistically significant after adjusting for receipt of riskreducing surgery.…”

Section: Long-term Psychiatric/psychological Impact Of Testingmentioning

confidence: 99%

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Psychiatric implications of cancer genetic testing

Hirschberg

Chan‐Smutko

Pirl

2014

Cancer

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As genetic testing for hereditary cancer syndromes has transitioned from research to clinical settings, research regarding its accompanying psychosocial effects has grown. Men and women being tested for hereditary cancer syndromes may experience some psychological distress while going through the process of testing or after carrier status is identified. Psychological distress appears to decrease over the course of the first year and it is typically not clinically significant. Longer term studies show mixed results with some mutation carriers continuing to experience elevated distress. Baseline distress is the greatest risk factor for both immediate (weeks-12 months) and long-term psychological distress (18 mo-8 years post genetic testing). In addition to baseline psychological distress, other risk factors can be identified to help identify individuals who may need psychosocial interventions during the genetic testing process. The challenges of providing clinical care to the growing population of individuals identified to be at increased risk for heritable cancers present opportunities for research and new models of care. Cancer 2015;121:341-60. V C 2014 American Cancer Society.KEYWORDS: BRCA1, BRCA2, HNPCC, Lynch syndrome, genetic testing, unaffected carrier, carrier, hereditary cancer syndrome, riskreducing surgeries, psychosocial. INTRODUCTIONSeveral familial cancer syndromes that confer a high lifetime risk of cancer can be identified with genetic testing, and greater numbers of men and women will consider testing as the availability and public awareness of genetic testing for cancer susceptibility continue to increase. Research to date suggests that these individuals will have varied emotional responses to the process of genetic testing as well as its results.When genetic testing for cancer syndromes first transitioned from research protocols to clinics, there was initial concern that it would be similar to genetic testing for Huntington disease. Many worried that knowing they are at high risk for cancer in the future may be too distressing for some individuals, possibly even leading to suicide. However, several systematic reviews focusing primarily on hereditary breast and ovarian cancer (HBOC) and Lynch syndrome, also known as hereditary nonpolyposis colon cancer (HNPCC), have demonstrated that most individuals who have a mutation identified in an associated gene cope well with the knowledge of their genetic status. 1-3 Data regarding psychological implications of the genetic testing process are the most robust for women who present for HBOC risk assessment, which involves discussion of the BRCA1 and BRCA2 genes, although there are increasing studies for HNPCC, familial adenomatous polyposis (FAP), and other hereditary cancer syndromes.Although the rates of distress in individuals undergoing genetic testing vary, they appear to be relatively small. Studies have demonstrated that approximately 6% to 24% of individuals undergoing genetic testing for a BRCA1/BRCA2-associated or HNPCC-associated mutations repo...

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Section: Discussionmentioning

confidence: 99%

Section: Long-term Psychiatric/psychological Impact Of Testingmentioning

confidence: 99%

Psychiatric implications of cancer genetic testing

Hirschberg

Chan‐Smutko

Pirl

2014

Cancer

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“…To measure adherence, we used the validated 8-item Morisky medication adherence scale [22] at follow-up. To assess the psychological impact of the PGx test results at followup, several questions were adapted from the Multidimensional Impact of Cancer Risk Assessment questionnaire [23]; answer responses were 'never', 'rarely', 'sometimes' and 'often'. Newly developed questions specific to pharmaco genetics were also included to assess patients' experience and prior knowledge and perceived value of testing.…”

Section: Patient Surveysmentioning

confidence: 99%

Patient Experiences with Pharmacogenetic Testing in a Primary Care Setting

et al. 2016

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Aim:To investigate patient experiences with pharmacogenetic (PGx) testing. Methods: Patients were offered PGx testing through a study on pharmacist-assisted delivery of PGx testing and invited to complete pre-and post-testing surveys about their experience. Results: Of 63 patients tested, 17 completed the baseline survey (27%). Interest in testing was mostly impacted by desire to inform selection of best treatment (n = 13). Seven of 12 patients that completed the follow-up survey indicated that their provider discussed the test result with them. Five patients understood their test result very or somewhat well. All would be likely to have PGx testing again. Conclusion: Patients perceived PGx testing to be useful, though more effort may be needed to improve patient-provider communication of test results.

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“…Importantly, our results suggest that phenotype-genotype information could predict changes in both psychological well-being as well as general health. However, many have noted that measuring general mood or other psychological states may lack sensitivity to the important and unique issues that surround genetic testing, 17,18 or screening.…”

Section: Impact Of Hemochromatosis Screening On Well-beingmentioning

confidence: 99%