Psychosocial impact of undergoing prostate cancer screening for men with <i><scp>BRCA</scp>1 or <scp>BRCA</scp>2</i> mutations

Bancroft, Elizabeth; Saya, Sibel; Page, Elizabeth; Myhill, Kathryn; Thomas, Sarah; Pope, Jennifer; Chamberlain, Anthony; Hart, Rachel; Glover, Wayne; Cook, Jackie; Rosario, Derek J.; Helfand, Brian T.; Selkirk, Christina G.; Longmuir, Mark; Eccles, Diana; Gadea, Neus; Brewer, Carole; Barwell, Julian; Salinas, Mónica; Greenhalgh, Lynn; Tischkowitz, Marc; Henderson, Alex; Evans, D. Gareth; Buys, Saundra S.; Eeles, Rosalind; Aaronson, Neil K.

doi:10.1111/bju.14412

Cited by 10 publications

(8 citation statements)

References 45 publications

(75 reference statements)

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“…When compared with normative data for the HADS score from a study of a large sample of general practice registrants in North West England,38 the prevalence of clinically significant anxiety and depression in carriers was not high. The HADS mean scores in carriers are also similar to those of other genetically high-risk populations 39 40…”

Section: Discussionsupporting

confidence: 67%

Psychosocial effects of whole-body MRI screening in adult high-risk pathogenic TP53 mutation carriers: a case-controlled study (SIGNIFY)

et al. 2019

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BackgroundGermline TP53 gene pathogenic variants (pv) cause a very high lifetime risk of developing cancer, almost 100% for women and 75% for men. In the UK, annual MRI breast screening is recommended for female TP53 pv carriers. The SIGNIFY study (Magnetic Resonance Imaging screening in Li Fraumeni syndrome: An exploratory whole body MRI) study reported outcomes of whole-body MRI (WB-MRI) in a cohort of 44 TP53 pv carriers and 44 matched population controls. The results supported the use of a baseline WB-MRI screen in all adult TP53 pv carriers. Here we report the acceptability of WB-MRI screening and effects on psychosocial functioning and health-related quality of life in the short and medium terms.MethodsPsychosocial and other assessments were carried out at study enrolment, immediately before MRI, before and after MRI results, and at 12, 26 and 52 weeks’ follow-up.ResultsWB-MRI was found to be acceptable with high levels of satisfaction and low levels of psychological morbidity throughout. Although their mean levels of cancer worry were not high, carriers had significantly more cancer worry at most time-points than controls. They also reported significantly more clinically significant intrusive and avoidant thoughts about cancer than controls at all time-points. There were no clinically significant adverse psychosocial outcomes in either carriers with a history of cancer or in those requiring further investigations.ConclusionWB-MRI screening can be implemented in TP53 pv carriers without adverse psychosocial outcomes in the short and medium terms. A previous cancer diagnosis may predict a better psychosocial outcome. Some carriers seriously underestimate their risk of cancer. Carriers of pv should have access to a clinician to help them develop adaptive strategies to cope with cancer-related concerns and respond to clinically significant depression and/or anxiety.

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Section: Discussionsupporting

confidence: 67%

Psychosocial effects of whole-body MRI screening in adult high-risk pathogenic TP53 mutation carriers: a case-controlled study (SIGNIFY)

et al. 2019

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“…Previous studies have reported a short-term increase in psychological distress in women undergoing breast cancer screening [ 40 , 47 , 58 ]. However, in the current study, similar to other high-risk populations (e.g., individuals who carry a BRCA1 , BRCA2 or TP53 pathogenic variant, or with a family history of breast and pancreatic cancer) undertaking MRI-based cancer surveillance, stable or decreased measures of psychological distress were reported [ 39 , 48 , 59 , 60 ]. In this study, some women with NF1 did demonstrate higher levels of anxiety and cancer worry prior to breast cancer screening, compared to other MRI-based screening studies [ 39 , 40 , 48 , 59 , 60 ], which persisted over the course of the study.…”

Section: Discussionsupporting

confidence: 50%

“…However, in the current study, similar to other high-risk populations (e.g., individuals who carry a BRCA1 , BRCA2 or TP53 pathogenic variant, or with a family history of breast and pancreatic cancer) undertaking MRI-based cancer surveillance, stable or decreased measures of psychological distress were reported [ 39 , 48 , 59 , 60 ]. In this study, some women with NF1 did demonstrate higher levels of anxiety and cancer worry prior to breast cancer screening, compared to other MRI-based screening studies [ 39 , 40 , 48 , 59 , 60 ], which persisted over the course of the study. Although the anxiety measures used in this study have not been commonly used in population studies in NF1, the higher rate of anxiety in NF1 is consistent with previous literature [ 18 , 21 ].…”

Section: Discussionsupporting

confidence: 50%

The psychological impact and experience of breast cancer screening in young women with an increased risk of breast cancer due to neurofibromatosis type 1

et al. 2021

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Women with neurofibromatosis type 1 (NF1) have an increased risk of developing early breast cancer with a poorer prognosis compared to the general population. Therefore, international management guidelines recommend regular screening in women with NF1 starting from 30 to 35 years. As the psychological impacts of breast cancer screening in other high-risk populations cannot be extended to women with NF1, due to increased incidence of cognitive and mental health issues, the psychological harms of breast screening in women with NF1 are unknown. Consequently, the aim of this study was to assess the psychological impact of breast cancer screening in women with NF1 attending an established risk management clinic. Twenty-eight women with NF1 (30–50 years) completed psychological well-being and patient experience questionnaires, administered across five time points, before and after their initial and second round annual breast screening visits. Preliminary findings demonstrated the screening regimen was well-tolerated, with most participants reporting high satisfaction with the screening process. Overall, no significant increase in psychological distress related to the breast screening process was identified, with mean cancer worry and anxiety scores decreasing over time. However, some women did experience negative aspects of screening and barriers to re-attendance at annual breast screening appointments. As some women with NF1 exhibited clinical levels of psychological distress prior to screening, efforts to identify those at risk and additional support to address concerns and expectations throughout the breast screening process may be beneficial. Supplementary Information The online version contains supplementary material available at 10.1007/s10689-021-00259-9.

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“…Results from previous studies in cancer patients showed that fear of cancer recurrence (FCR), defined as fear, worry, or concern about cancer returning or progressing, has been identified as one of the most common psychological challenges 8,9 . Studies on cancer worry in screening populations are limited and primarily conducted in screening populations with increased cancer risk 10,11 . Previous meta‐analyses in breast cancer screening have shown that false‐positive screening examinations affect psychosocial functioning that can persist for up to 3 years after the screening 12,13 .…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Studies on cancer worry in screening populations are limited and primarily conducted in screening populations with increased cancer risk. 10,11 Previous meta-analyses in breast cancer screening have shown that false-positive screening examinations affect psychosocial functioning that can persist for up to 3 years after the screening. 12,13 Available studies on screen-related psychological distress in CRC screening show that an adverse effect on psychological wellbeing exists.…”

Section: Introductionmentioning

confidence: 99%

Psychological distress and quality of life following positive fecal occult blood testing in colorectal cancer screening

et al. 2020

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Objective This study aimed to assess psychological functioning, quality of life, and regret about screening after a positive fecal immunochemical test (FIT) and subsequent colonoscopy, and to evaluate changes over time. Methods This is a prospective cohort study. Individuals aged 55 to 75 with a positive FIT that were referred for colonoscopy between July 2017 and November 2018, were invited to complete questionnaires related to psychological distress and health‐related quality of life at three predefined time points: before colonoscopy, after histopathology result notification, and after 6 months. Four questionnaires were used: the Psychological Consequences Questionnaire (PCQ), the six‐item Cancer Worry Scale (CWS), the Decision Regret Scale (DRS), and the 36‐item Short‐Form (SF‐36). Results A total of 1066 participants out of 2151 eligible individuals were included. Patients with cancer showed a significant increase in psychological dysfunction (P = .01) and cancer worry (P = .008) after colonoscopy result notification, and a decline to pre‐colonoscopy measurements after 6 months. In the no‐cancer groups, psychological dysfunction and cancer worry significantly decreased over time (P < .05) but there was no ongoing decline. After 6 months, 17% of participants with no cancer experienced high level of cancer worry (CWS ≥ 10). Yet, only 5% reported high level of regret about screening participation (DRS > 25). A good global quality of life was reported in participants with no cancer. Conclusion Some psychological distress remains up to 6 months after colonoscopy in participants who tested false‐positive in the Dutch bowel cancer screening program.

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Psychosocial impact of undergoing prostate cancer screening for men with BRCA1 or BRCA2 mutations

Cited by 10 publications

References 45 publications

Psychosocial effects of whole-body MRI screening in adult high-risk pathogenic TP53 mutation carriers: a case-controlled study (SIGNIFY)

Psychosocial effects of whole-body MRI screening in adult high-risk pathogenic TP53 mutation carriers: a case-controlled study (SIGNIFY)

The psychological impact and experience of breast cancer screening in young women with an increased risk of breast cancer due to neurofibromatosis type 1

Psychological distress and quality of life following positive fecal occult blood testing in colorectal cancer screening

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