Browsed by
Tag: genetic testing

Changes in patients’ family communication after offer of skin cancer genetic test

Changes in patients’ family communication after offer of skin cancer genetic test

Melanoma is a serious preventable form of skin cancer. Genetic testing for skin cancer risk may help increase awareness. A team led by Dr. Jennifer Hay from the Memorial Sloan Kettering Cancer Center, and including Dr David Buller from Klein Buendel, examined how an offer for testing for the melanocortin-1 receptor gene (MC1R) may have enhanced communication surrounding skin cancer within families. The research team presented a poster of their findings at the 44th Annual Sessions and Meeting of the Society of Behavioral Medicine in Phoenix, Arizona on April 26-29, 2023.

The study examined frequency targets (which family member) and topics of family communication around skin cancer at a 3-month follow-up within a New Mexico study that randomized primary care patients (N=600; 48% Hispanic) to MC1R test invitation or usual care (Aim 1). Frequency and targets were assessed on 4-point scales (“not at all” to “a lot”) asking participants how often they talked with family and with each target. Topics were assessed by asking participants whether they discussed a series of topics with family. The impact of usual care genetic test refusal and test results (average or higher risk feedback) on frequency targets and topics of family communication was assessed using ANOVAs and Chi-Square tests (Aim 2).

Aim 1 analysis showed that at the 3-month follow-up the average frequency of overall family communication was between “a little” and “some”. The most common communication targets were spouses and children; the most common topic was sun protection. Aim 2 analysis showed no significant differences in communication frequency. However, communication targets who received high-risk feedback reported greater communication with their spouse compared to those in usual care. Lastly, the study found that certain topics of communication such as “who had skin cancer in the family” and “your own risk of getting skin cancer” were discussed more by those who had testing (both receiving average and high-risk feedback) than by those in usual care or by test refusers.

The findings provide important insight into family communication about skin cancer. The results indicate greater discussion with certain people and about certain topics when individuals had undergone genetic testing highlighting the potential role that genetic testing can play in fostering family communication. Future research could provide deeper insight into why individuals talk to certain people and about certain topics more than others as well as examine how family communication affects decision-making regarding offers for cascade genetic testing or interpretation of results.

This research was supported by a grant from the National Cancer Institute (CA181241; Dr. Jennifer Hay and Dr. Marianne Berwick, Multiple Principal Investigators). Authors in addition to Dr. Jennifer Hay include Ms. Caroline Salafia (poster presenter), Dr. Smita Banerjee, and Ms. Elizabeth Schofield from the Memorial Sloan Kettering Cancer Center; Dr. Andrew Sussman, Dr. Dolores Guest, and Dr. Keith Hunley from the University of New Mexico; Dr. Kimberly Kaphingst from the University of Utah; and Dr. David Buller from Klein Buendel.

Skin Cancer Genetic Testing Research

Skin Cancer Genetic Testing Research

Klein Buendel Director of Research, Dr. David Buller, is a co-author on two recent publications reporting the results of studies on genetic testing and treatment decision-making for melanoma patients. Both papers report finding from a study directed by Dr. Jennifer Hay from the Memorial Sloan Kettering Cancer Center in New York and Dr. Marianne Berwick from the University of New Mexico.

Behavioral and Psychological Outcomes Associated with Skin Cancer Genetic Testing

The first paper has been published in the journal Cancer (Basel). The study investigated genomic testing of the common melanocortin-1 receptor (MC1R) gene for skin cancer risk in a randomized controlled trial in primary care settings in Albuquerque, New Mexico. Study participants were randomized 5:1 to a MC1R test invitation or usual care. Three-month sun protection, skin cancer screening, and skin cancer worry outcomes associated with testing, and key effect moderators (such as cancer risk perceptions, and skin cancer risk factors) were assessed.

Full research methods and results are reported in the publication and show that the primary outcomes were unchanged by the MC1R test offer, test acceptance, and level of risk feedback. Moderator analyses results are also presented in the publication. “Risk feedback did not prompt cancer worry, and average risk feedback did not erode existing sun protection,” according to the authors. More study is needed in the understanding and development of tailored strategies to address low skin cancer risk awareness and genetic testing.

This research was supported by the National Cancer Institute (CA181241; Jennifer Hay and Marianne Berwick, Multiple Principal Investigators). Collaborators include Kimberly Kaphingst from the University of Utah; David Buller from Klein Buendel; Elizabeth Schofield and Yuelin Li from the Memorial Sloan Kettering Cancer Center; Kirsten Meyer White from the New Mexico VA Health System; Andrew Sussman, Dolores Guest, Yvonne Dailey, Erika Robers, Matthew Schwartz, and Keith Hunley from the University of New Mexico.

Effect of Superstitious Beliefs and Risk Intuitions on Genetic Test Decisions

The second paper has been published in the journal Medical Decision Making. The study investigated cognitive causation, or superstitious thinking, and negative affect in risk as predictors of MC1R (moderate v. high risk) skin cancer genetic testing and responses to the testing.

Nearly 500 participants completed baseline assessments using validated measures of cognitive causation (beliefs that thinking about cancer risk increases cancer likelihood) and negative affect in risk (negative feelings generated during risk perception) and subsequently received a test offer. Participants could access a website to learn about and request genetic testing. Those who completed genetic testing for skin cancer completed assessments of cognitive and affective reactions two weeks after testing.

Methods, assessment measures, and full results are reported in the publication. In summary, negative affect in risk did not hamper test information seeking, but did inhibit the uptake of genetic testing. Those with higher cognitive causation showed more fear regarding their test result.

This research was supported by the National Cancer Institute (CA181241; Jennifer Hay and Marianne Berwick, Multiple Principal Investigators). Collaborators include Kristen Riley from Rutgers University; Andrew Sussman, Dolores Guest, Yvonne Dailey, Matthew Schwartz, and Keith Hunley from the University of New Mexico; Elizabeth Schofield from the Memorial Sloan Kettering Cancer Center; David Buller from Klein Buendel; and Kimberly Kaphingst from the University of Utah.