Psychosocial Interventions for Women with a BRCA1 or BRCA2 Mutation: A Scoping Review

Boghosian, Talin; McCuaig, Jeanna; Carlsson, Lindsay; Metcalfe, Kelly

doi:10.3390/cancers13071486

Cited by 15 publications

(7 citation statements)

References 45 publications

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“…Anxiety and depression have been known to increase both during and after genetic testing for BRCA1/2 mutations [12][13][14]. For some populations such as Hispanic women, testing positive for BRCA1/2 mutations may feel like a death sentence, because breast cancer is the leading cause of death among this group and increase feelings of hopelessness, stress, and anxiety [52].…”

Section: Discussionmentioning

confidence: 99%

“…Adverse mental health outcomes coexist with the impending risk of breast and ovarian cancers among BRCA1/2positive women in conjunction with associated prophylactic surgeries and ongoing surveillance that are necessary for health maintainence [12][13][14]. The constant worry about affected family members, risk of cancer, future childrearing, among others has a negative effect on mental health [14][15][16], health-related quality of life [17] (especially after prophylactic surgery [18,19]), and perceived health [20,21] among this population.…”

Section: Introductionmentioning

confidence: 99%

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Anxiety and depression among racial/ethnic minorities and impoverished women testing positive for BRCA1/2 mutations in the United States

Dibble

Connor

2022

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PurposeTo outline the association between race/ethnicity and poverty status and perceived anxiety and depressive symptomologies among BRCA1/2-positive United States (US) women to identify high-risk groups of mutation carriers from medically underserved backgrounds. Methods 211 BRCA1/2-positive women from medically underserved backgrounds were recruited through national Facebook support groups and completed an online survey. Adjusted odds ratios (aOR) and 95% con dence intervals (CIs) were estimated using multivariable logistic regression for associations between race/ethnicity, poverty status, and self-reported moderate-to-severe anxiety and depressive symptoms. ResultsWomen ranged in age (18-75, M = 39.5, SD = 10.6). Most women were non-Hispanic white (NHW) (67.2%) and were not impoverished (76.7%). Hispanic women with BRCA1/2 mutations were 6.11 times more likely to report moderate-to-severe anxiety (95% CI, 2.16-17.2, p = 0.001) and 4.28 times more likely to report moderate-to-severe depressive symptoms (95% CI, 1.98-9.60, p = < 0.001) than NHW women with BRCA1/2. Associations were not statistically signi cant among other minority women. Women living in poverty were signi cantly less likely to report moderate-to-severe depressive symptoms than women not in poverty (aOR, 0.42, 95% CI, 0.18-0.95, p = 0.04). ConclusionHispanic women with BRCA1/2 mutations from medically underserved backgrounds are an important population at increased risk for worse anxiety and depressive symptomology. Our ndings among Hispanic women with BRCA1/2 mutations add to the growing body of literature focused on ethnic disparities experienced across the cancer control continuum. impoverished women. Furthermore, the impact on mental health among BRCA1/2-positive women from racial/ethnic and impoverished groups remains relatively unknown, as past literature has targeted racial/ethnic minority women from one location due to di culty in recruitment [29,30].Objectives. The current study aims to outline the association between race/ethnicity and poverty status and perceived anxiety and depressive symptomologies among BRCA1/2-positive US women to identify high-risk groups of mutation carriers from medically underserved backgrounds. Women with BRCA1/2 mutations may experience adverse mental health symptomologies related to their mutations and ongoing care, and we hypothesize that racial/ethnic minority and impoverished women may face an even more heightened threat. Methods Study Design & Sample

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anxiety and depression among racial/ethnic minorities and impoverished women testing positive for BRCA1/2 mutations in the United States

Dibble

Connor

2022

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“…Various studies have assessed psychological wellbeing and morbidity in BRCA1/2 pathogenic variant carriers, both qualitatively [ 19 , 21 , 22 , 23 , 24 ] and quantitatively [ 25 , 26 , 27 ]. Previous reviews have attempted to condense the evidence available [ 12 , 20 , 26 , 28 , 29 , 30 , 31 ]. However, these reviews (1) have focused on the efficacy of psychosocial interventions [ 28 , 29 ], (2) have focused on the psychological effects of different risk-management strategies [ 12 , 31 ], (3) have only included cancer-affected BRCA1/2 carriers [ 30 ], or (4) have reported men and women or cancer-unaffected and cancer-affected BRCA1/2 pathogenic variant carriers combined [ 20 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing Psychological Morbidity in Cancer-Unaffected BRCA1/2 Pathogenic Variant Carriers: A Systematic Review

et al. 2023

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Female BRCA1/2 pathogenic variant carriers have an increased lifetime risk for breast and ovarian cancer. Cancer-unaffected women who are newly diagnosed with this pathogenic variant may experience psychological distress because of imminent health threat. No comprehensible review on psychological morbidity in cancer-unaffected BRCA1/2 pathogenic variant carriers is currently available. This review aims to give an overview about all available the studies in which psychological outcomes have been assessed in cancer-unaffected BRCA1/2 pathogenic variant carriers, whether as a primary outcome or secondary measurement. A systematic search across four databases (Web of Science, PubMed, ScienceDirect, and EBSCO) was conducted. Studies had to report on cancer-unaffected pathogenic variant carriers (exclusively or separately) and use a validated measure of psychological morbidity to be eligible. Measures were only included if they were used in at least three studies. The final review consisted of 45 studies from 13 countries. Distress measures, including anxiety and cancer worry, were most often assessed. Most studies found a peak of distress immediately after genetic test result disclosure, with a subsequent decline over the following months. Only some studies found elevated distress in carriers compared to non-carriers in longer follow-ups. Depression was frequently investigated but largely not found to be of clinical significance. Quality of life seemed to be largely unaffected by a positive genetic test result, although there was some evidence that younger women, especially, were less satisfied with their role functioning in life. Body image has been infrequently assessed so far, but the evidence suggested that there may be a decrease in body image after genetic test result disclosure that may decrease further for women who opt for a prophylactic mastectomy. Across all the outcomes, various versions of instruments were used, often limiting the comparability among the studies. Hence, future research should consider using frequently used instruments, as outlined by this review. Finally, while many studies included cancer-unaffected carriers, they were often not reported on separately, which made it difficult to draw specific conclusions about this population.

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“…In a data repository study conducted by Myriad Genetics, BRCA1/2 mutations were found in 14.8%, 15.6%, 12.7%, and 13.2% of tested Hispanic, African, Asian, and Native American women, respectively. Previous literature has focused heavily on the psychosocial impact of receiving a BRCA1/2 diagnosis [21][22][23] and undergoing surgery or surveillance for risk reduction or early detection [24][25][26]. Unfortunately, most of these studies have sampled high-risk English-speaking non-Hispanic white women [22,25,27], such as Ashkenazi Jewish populations [28][29][30], limiting the generalizability that genetic testing and BRCA1/2-related experiences have to racial/ethnic groups.…”

Section: Introductionmentioning

confidence: 99%

Residential Locale Is Associated with Disparities in Genetic Testing-Related Outcomes Among BRCA1/2-Positive Women

Dibble

Connor

2022

J. Racial and Ethnic Health Disparities

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Background While research on hereditary genetic testing for BRCA1/2 mutations continues to emerge, there remain unanswered questions regarding access to testing and cancer-related care. Our study determined the associations between race/ ethnicity, residential locale, and genetic testing provider and related outcomes among US women with BRCA1/2 genetic mutations. Methods One hundred ninety-three BRCA1/2-positive women from vulnerable health backgrounds were recruited via private national Facebook BRCA1/2-oriented support groups and completed an online survey. Adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression for the associations between race/ethnicity, residential locale, and genetic testing-related outcomes. Results Women ranged in age (18-75, M = 39.5, SD = 10.7), and most were non-Hispanic white (66.3%) and lived in a suburban locale (54.9%). Women living in suburban areas were significantly less likely (aOR, .369, 95% CI, .177-.771) to receive behavioral referrals after genetic testing compared to those living in an urban locale. Women living in rural areas and suburban areas were 4.72 times more likely (95% CI, 1.48-15.1, p = .009) and 2.61 times more likely (95% CI, 1.05-6.48, p = .038), respectively, to receive genetic testing from a primary care provider versus private genetic testing office/hospital compared to women in urban locales. Associations between race/ethnicity and genetic testing outcomes were not statistically significant. Residential locale did not predict the odds of undergoing surgery for risk reduction or surveillance for early detection. ConclusionOur study identifies disparities in genetic testing resources among women living in suburban and rural areas. These findings can be used to inform future care, research, and community resources that may impact services relating to genetic testing within these locales. Keywords Residential disparities • Racial/ethnic disparities • Genetic testing • Health access • Breast cancer Abbreviations BRCA Breast cancer DTC Direct-to-consumer NHW Non-Hispanic white PCP Primary care provider US United States

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Psychosocial Interventions for Women with a BRCA1 or BRCA2 Mutation: A Scoping Review

Cited by 15 publications

References 45 publications

Anxiety and depression among racial/ethnic minorities and impoverished women testing positive for BRCA1/2 mutations in the United States

Anxiety and depression among racial/ethnic minorities and impoverished women testing positive for BRCA1/2 mutations in the United States

Assessing Psychological Morbidity in Cancer-Unaffected BRCA1/2 Pathogenic Variant Carriers: A Systematic Review

Residential Locale Is Associated with Disparities in Genetic Testing-Related Outcomes Among BRCA1/2-Positive Women

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