Deborah J Bowen1, Sukh Makhnoon2, Brian H Shirts3, Stephanie M Fullerton4, Eric Larson5, James D Ralston6, Kathleen Leppig7, David R Crosslin8, David Veenstra9, Gail P Jarvik10. 1. Department of Bioethics and Humanities, University of Washington, Seattle, USA. Electronic address: dbowen@uw.edu. 2. Department of Behavioral Science, UT MD Anderson Cancer Center, Houston, USA. 3. Department of Laboratory Medicine, University of Washington, Seattle, USA. 4. Department of Bioethics and Humanities, University of Washington, Seattle, USA. 5. Kaiser Permanente Washington Health Research Institute, Seattle, USA. 6. Kaiser Permanente Washington Health Research Institute, Seattle, USA; Department of Bioinformatics and Medical Education, University of Washington, Seattle, USA. 7. Genetic Services, Kaiser Permanente Washington Health Research Institute, Seattle, USA. 8. Department of Bioinformatics and Medical Education, University of Washington, Seattle, USA. 9. Department of Pharmacy, University of Washington, Seattle, USA. 10. Departments of Medicine (Medical Genetics) and Genome Sciences, University of Washington Medical Center, Seattle, USA.
Abstract
OBJECTIVE: We currently rely on probands to communicate genetic testing results and health risks within a family to stimulate preventive behaviors, such as cascade testing. Rates of guidelines-based cascade testing are low, possibly due to low frequency or non-urgent communication of risk among family members. Understanding what is being communicated and why may help improve interventions that increase communication and rates of cascade testing. METHODS: Participants (n = 189) who were to receive both positive and negative colorectal cancer (CRC) sequencing results completed surveys on family communication, family functioning, impact of cancer in the family, and future communication of risk and were participants in eMERGE3. Questions were taken from existing surveys and administered electronically using email and a web driven tool. RESULTS: Common family member targets of CRC risk communication, before results were received, were mothers and fathers, then sisters and grandchildren and finally, children and brothers. A communication impact score of 0.66 (sd = 0.83) indicated low-to-moderate communication impact. Age and education were significantly associated with frequency of familial communication, but not on the cancer-related impact of familial communication. CONCLUSIONS: There is infrequent communication about cancer risk from probands to family members. PRACTICE IMPLICATIONS: These results demonstrate an opportunity to help families improve communication.
OBJECTIVE: We currently rely on probands to communicate genetic testing results and health risks within a family to stimulate preventive behaviors, such as cascade testing. Rates of guidelines-based cascade testing are low, possibly due to low frequency or non-urgent communication of risk among family members. Understanding what is being communicated and why may help improve interventions that increase communication and rates of cascade testing. METHODS: Participants (n = 189) who were to receive both positive and negative colorectal cancer (CRC) sequencing results completed surveys on family communication, family functioning, impact of cancer in the family, and future communication of risk and were participants in eMERGE3. Questions were taken from existing surveys and administered electronically using email and a web driven tool. RESULTS: Common family member targets of CRC risk communication, before results were received, were mothers and fathers, then sisters and grandchildren and finally, children and brothers. A communication impact score of 0.66 (sd = 0.83) indicated low-to-moderate communication impact. Age and education were significantly associated with frequency of familial communication, but not on the cancer-related impact of familial communication. CONCLUSIONS: There is infrequent communication about cancer risk from probands to family members. PRACTICE IMPLICATIONS: These results demonstrate an opportunity to help families improve communication.
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