abstract
Psychosocial outcomes and counselee satisfaction following genetic counseling for hereditary breast and ovarian cancer: A patient-reported outcome study
OBJECTIVE:
We
investigated the psychosocial consequences of genetic counseling and
testing (GCT) for hereditary breast and ovarian cancer (HBOC) at
follow-up in a
"real-life" sample of counselees at an Austrian tertiary
care center.
METHODS:
The
study cohort included counselees who had undergone genetic counseling
for HBOC and completed a follow-up self-report questionnaire battery on
psychosocial outcomes (quality of life, psychological distress,
satisfaction with counseling and decisions).
For comparison of distress,
we recruited a reference sample of breast cancer survivors (BCS; n=665)
who had not requested GCT in the same setting.
RESULTS:
Overall,
counselees did not exhibit increased levels of anxiety and depression
when compared to BCS. No specific follow-up deleterious psychosocial
consequences were detected among the former group. Of the 137
counselees, 22.6% and 9.8% experienced clinically relevant levels of
anxiety and depression, respectively, at an average follow-up time of
1.8years. However, both anxiety and depression significantly decreased
with time and were alike between counselees with and without cancer
diagnosis.
Follow-up cancer worry seems to be significantly higher among
counselees who had not undergone genetic testing or were undecided
about it than among counselees who had been tested.
CONCLUSION:
Our
results strongly support GCT as part of routine care for patients with
HBOC. The risk factors of increased distress in specific subgroups of
counselees, such as recent cancer diagnosis or uncertainty about
testing, warrant further exploration and specific attention in clinical
routines. Particularly, the psychological needs of undecided counselees
warrant ongoing attention and potential follow-ups.
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