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Psychiatric implications of cancer genetic testing
Authors:April Malia Hirschberg MD  Gayun Chan‐Smutko MS  CGC  William F. Pirl MD  MPH
Affiliation:1. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts;2. Cancer Center, Massachusetts General Hospital, Boston, Massachusetts
Abstract:As genetic testing for hereditary cancer syndromes has transitioned from research to clinical settings, research regarding its accompanying psychosocial effects has grown. Men and women being tested for hereditary cancer syndromes may experience some psychological distress while going through the process of testing or after carrier status is identified. Psychological distress appears to decrease over the course of the first year and it is typically not clinically significant. Longer term studies show mixed results with some mutation carriers continuing to experience elevated distress. Baseline distress is the greatest risk factor for both immediate (weeks‐12 months) and long‐term psychological distress (18 mo‐8 years post genetic testing). In addition to baseline psychological distress, other risk factors can be identified to help identify individuals who may need psychosocial interventions during the genetic testing process. The challenges of providing clinical care to the growing population of individuals identified to be at increased risk for heritable cancers present opportunities for research and new models of care. Cancer 2015;121:341–360. © 2014 American Cancer Society.
Keywords:BRCA1  BRCA2  HNPCC  Lynch syndrome  genetic testing  unaffected carrier  carrier  hereditary cancer syndrome  risk‐reducing surgeries  psychosocial
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