PSYCHOLOGICAL ISSUES IN CANCER GENETICS - CURRENT RESEARCH AND FUTUREPRIORITIES

There has been a rapid expansion of genetics research in the field of cancer since cancer predisposing genes are now known to cause a propor tion of common cancers as well as rarer cancer syndromes. As a result, the psychosocial impact of being at high risk of cancer has become a focus of evaluation, and studies are being reported which set out to e valuate both the uptake and psychological outcome of genetic counselli ng, testing and surveillance. Available data concerning psychological aspects are reviewed, including for example, possible implications of genetic testing, attitudes and uptake of breast screening and accuracy of women's risk estimates. Work is in progress to assess the more con troversial areas of prophylactic mastectomy, and chemoprevention. Othe r research examines the longer term impact of belonging to a Cancer Fa mily, and of interventions offered to high risk families. This is cruc ial since the uptake of counselling and testing is likely to be much g reater in cancer prone families than those with other genetic disorder s, yet detection and prevention strategies are still unevaluated for i mportant genetically determined cancers such as breast cancer. (C) 199 7 Elsevier Science Ireland Ltd.