A comparison of male attendees and nonattendees at a familial cancer clinic

Abstract

; kConFab InvestigatorsPurpose: This retrospective descriptive Australian study aimed to determine predictors of nonattendance at a familial cancer clinic by men from high-risk breast/ovarian cancer families. Methods: Two hundred twenty-six men from families with a known BRCA1 or BRCA2 mutation were recruited through an epidemiological database of high-risk breast cancer families and completed a self-administered questionnaire. Results: Multivariate analyses using binary logistic regression showed that nonattendance at a familial cancer clinic by men from high-risk breast/ovarian cancer families was associated with younger age (51 vs. 55 years) (odds ratio ϭ 1.03, P ϭ 0.04) and lower cancer burden (one relative diagnosed versus two relatives diagnosed) (odds ratio ϭ 2.6, P ϭ 0.04). Conclusion: Compared with men who attended a familial cancer clinic, nonattendees were younger and had fewer relatives diagnosed with breast/ovarian cancer. Unlike previous findings, cancer-specific worry, in particular avoidance was not associated with nonattendance. The number, age, and sex of biological children were not associated with attendance or nonattendance. Hence, some of the assumptions about what makes information on BRCA1 or BRCA2 status salient to men and may therefore influence their attendance at a cancer genetic clinic are not borne out in this study. Genet Med 2009:11(11):806 -811.Key Words: BRCA1, BRCA2, men, familial cancer clinics E xtensive data from surveys conducted in Canada, 1 the Netherlands, 2,3 the United Kingdom, 4,5 and France 6,7 detail the characteristics of women who attend familial cancer clinics (FCCs) and who decide to have genetic testing. Self-reported reasons cited by many women in different countries for attending FCCs include desire to know personal and family risk, awareness of family history, need for reassurance, desire for genetic testing, and to find out about breast cancer screening or prevention. 5,6,8,9 A strong motivating factor seems to be concern about personal risk triggered by the diagnosis of (or death from) breast cancer in a first-degree relative. 4,10 A recent review indicates that women who attended and choose to have genetic testing were more likely to be affected with cancer, have higher levels of cancer anxiety and perceived risk, and larger numbers of relatives diagnosed with cancer. 11 Less data are available on men's motivations for attending genetic counseling. Fewer men than women are referred and accept genetic counseling.9,12 Men who do take up genetic counseling have a tendency to miss appointments, drop out of testing protocols, 13 and experience difficulties in establishing appropriate post-test care.14 Hallowell et al. 15 reported that men's decisions to have genetic testing were motivated by a desire to obtain information for their kin and a sense of obligation to determine the carrier status of their children. Their decision to undergo testing was also influenced by family members such as partners and adult children. 15 Studies also report that men from famil...

Sociodemographic, psychosocial and clinical factors associated with uptake of genetic counselling for hereditary cancer: a systematic review

“…Being married was a significant predictor of GC uptake in three studies (20,22,37), and was not significantly associated in eight (19,23,25,27,35,39,42,43).…”

“…Higher income was a significant predictor of uptake in two studies (22,40), but was not associated in three (19,35,43). Being employed was significantly associated with uptake in two studies (20,32), but was not associated in another five studies (21,35,39,40,42). Higher social class (based on occupation) and lower social deprivation (based on postcode) were significantly associated with GC uptake (14,23).…”

“…Higher level of education was a significant predictor of GC uptake in six studies (20-22, 29, 32, 35); one study observed a positive trend approaching significance (19); and no significant effect of education was observed in seven studies (25,27,37,39,40,42,43).…”

“…Younger age was a significant predictor of BRCA1/2 GC uptake in six studies (21-23, 25, 38, 42), and Lynch syndrome GC uptake in one study (24) and older age was a significant predictor of uptake in three studies of familial melanoma, BRCA1/2 and Lynch syndrome (14,30,39). (43) a Association significant at multivariate level.…”

“…Five studies found a positive association between cancer-specific distress and GC uptake using the Impact of Events Scale (IES) (37,39,43), the Cancer Worry Scale (25) or purposively designed items (22). No difference in cancer-specific distress was observed between attenders and decliners in five studies, three using the IES (25,40,42), one using the Cancer Worry Scale (32) and another measuring 'cancer-related concern' (19).…”