C. Lerman et al., GENETIC TESTING FOR COLON-CANCER SUSCEPTIBILITY - ANTICIPATED REACTIONS OF PATIENTS AND CHALLENGES TO PROVIDERS, International journal of cancer, 69(1), 1996, pp. 58-61
The commercial availability of genetic tests for colon cancer suscepti
bility is creating new opportunities and challenges for both patients
and providers. To provide information useful in the education and coun
seling of individuals considering genetic testing, we conducted struct
ured interviews with 45 male and female first-degree relatives of colo
rectal cancer patients. Fifty-one percent of respondents indicated tha
t they definitely would want to obtain a genetic test. for colon cance
r susceptibility when it is available and 31% said that they probably
would want to be tested. Interest in genetic testing was significantly
higher among persons with less formal education and those with a Cath
olic religious preference. Motivations for genetic testing included th
e following: to know if more screening tests are needed, to learn if o
ne's children are at risk and to be reassured. Barriers to testing inc
luded concerns about insurance, test accuracy and how one's family wou
ld react emotionally. Most participants anticipated that they would be
come depressed and anxious if they tested positive for a mutation, whi
le many would feel guilty and still worry if they tested negative. Of
note, about one-half of respondents expected that they would decrease
their use of screening tests and make fewer attempts to reduce dietary
fat if they tested negative. These preliminary results underscore the
importance of educating patients about the potential risks, benefits
and limitations of genetic testing, with particular emphasis on the po
ssibility of adverse psychological effects and implications for health
insurance. The potential for false reassurance following a negative t
est result should be addressed by emphasizing the residual risks of ca
ncer among non-carriers of predisposing mutations. (C) 1996 Wiley-Liss
, Inc.