Women Who Seek BRCA1 Testing May Be More Distressed and Psychologically Vulnerable

August 1, 1997

NEW ORLEANS--Women seeking BRCA1 testing appear, as a group, to be more distressed and psychologically vulnerable than those who do not wish to be tested, according to two studies from Lombardi Cancer Center, Georgetown University, reported at the American Society of Preventive Oncology annual meeting. The women in the studies were at high risk because of a close family history of breast or ovarian cancer.

NEW ORLEANS--Women seeking BRCA1 testing appear, as a group, to be moredistressed and psychologically vulnerable than those who do not wish tobe tested, according to two studies from Lombardi Cancer Center, GeorgetownUniversity, reported at the American Society of Preventive Oncology annualmeeting. The women in the studies were at high risk because of a closefamily history of breast or ovarian cancer.

Janet Audrain, PhD, evaluated 256 women who self-referred for genetictesting. She found mild to moderate distress levels in the group as a whole.

Women with higher levels of general distress were less likely to bemarried, less optimistic, and had heightened breast cancer risk perceptions,accompanied by feelings of low perceptions of control over the developmentof breast cancer, Dr. Audrain reported at a poster session.

Women with higher levels of cancer-specific distress tended to be younger,nonwhite, and had low perceptions of control over developing breast cancer.

Marc Schwartz, PhD, reported that the presence of stress symptoms maymotivate individuals to seek BRCA1 testing, and that women with such symptomsmay be more vulnerable to adverse psychological effects.

Dr. Schwartz' study included 149 participants who were offered geneticcounseling and BRCA1 test results. Overall, 58% of the participants requestedthe test results and 42% declined. Women who had the most baseline stresssymptoms were the most likely to request the genetic test.

Women with the most baseline stress also tended to be the most depressedone month after receiving a positive test result. Baseline levels of globaldistress or depressive symptoms did not correlate with effect of the testresults, Dr. Schwartz reported.

Counseling May Be Warranted

"These results suggest that the presence of stress symptoms maymotivate individuals to seek BRCA1 testing, and that individuals with suchsymptoms may be more vulnerable to adverse psychological effects and maywarrant counseling," he said.