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Published in: Familial Cancer 4/2010

01-12-2010

Pancreatic cancer risk counselling and screening: impact on perceived risk and psychological functioning

Authors: Christine Maheu, Andrea Vodermaier, Heidi Rothenmund, Steve Gallinger, Paola Ardiles, Kara Semotiuk, Spring Holter, Saumea Thayalan, Mary Jane Esplen

Published in: Familial Cancer | Issue 4/2010

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Abstract

Individuals at increased risk for pancreatic cancer who undergo screening can experience psychological and emotional distress. The objective of this study is to determine whether individuals participating in a pancreatic cancer screening program experience disruptions in risk perception, cancer-related anxiety or emotional distress. A pretestposttest design was used to examine perceived risk and psychological functioning of individuals participating in a pancreatic cancer screening protocol. The screening protocol includes genetic counselling, transcutaneous abdominal ultrasound, magnetic resonance imaging, and blood collection and eligible participants included individuals with a family history of pancreatic cancer or BRCA2 mutation carriers. At baseline, participants (n = 198) showed low to moderate levels of risk perception, pancreatic cancer-related anxiety, and general distress. Participants with familial pancreatic cancer (FPC) (n = 131) endorsed higher risk perception of pancreatic cancer than the BRCA2 carriers (n = 67) (perceived lifetime risk 42 vs. 15%), but did not differ on cancer worry or general distress prior to the first study appointment. From baseline to 3 months follow-up, no significant time or time by group interactions emerged on risk perception or general distress, but cancer worry decreased over time for the FPC group regardless of the number of affected relatives. Our findings indicate that participation in a pancreatic cancer screening program does not lead to a significant increase in risk perception, cancer worry, or general distress and that participants with high baseline levels of risk perception and distress may benefit from a more comprehensive risk assessment and psychological support.
Literature
1.
go back to reference CCS/NCIC (2008) Canadian Cancer Statistics 2008. In: Society CC (ed) Canadian Cancer Society/National Cancer Institute of Canada. Vol 2008, Toronto CCS/NCIC (2008) Canadian Cancer Statistics 2008. In: Society CC (ed) Canadian Cancer Society/National Cancer Institute of Canada. Vol 2008, Toronto
2.
go back to reference Birk D, Fortnagel G, Formentini A, Beger HGS (1998) Mall carcinoma of the pancreas. Factors of prognostic relevance. J Hepatobiliary Pancreat Surg 5:450–454CrossRefPubMed Birk D, Fortnagel G, Formentini A, Beger HGS (1998) Mall carcinoma of the pancreas. Factors of prognostic relevance. J Hepatobiliary Pancreat Surg 5:450–454CrossRefPubMed
3.
go back to reference Cleary SP, Gryfe R, Guindi M, Greig P, Smith L, Mackenzie R, Strasberg S, Hanna S, Taylor B, Langer B, Gallinger S (2004) Prognostic factors in resected pancreatic adenocarcinoma: analysis of actual 5-year survivors. J Am Coll Surg 198:722–731CrossRefPubMed Cleary SP, Gryfe R, Guindi M, Greig P, Smith L, Mackenzie R, Strasberg S, Hanna S, Taylor B, Langer B, Gallinger S (2004) Prognostic factors in resected pancreatic adenocarcinoma: analysis of actual 5-year survivors. J Am Coll Surg 198:722–731CrossRefPubMed
4.
go back to reference AGA (1999) American Gastroenterological Association Medical position statement: epidemiology, diagnosis, and treatment of pancreatic ductal adenocarcinoma. Gastroenterology 117:1463–1484CrossRef AGA (1999) American Gastroenterological Association Medical position statement: epidemiology, diagnosis, and treatment of pancreatic ductal adenocarcinoma. Gastroenterology 117:1463–1484CrossRef
5.
go back to reference Lal G, Liu G, Schmocker B, Kaurah P, Ozcelik H, Narod SA, Redston M, Gallinger S (2000) Inherited predisposition to pancreatic adenocarcinoma: role of family history and germ-line p16, BRCA1, and BRCA2 mutations. Cancer Res 60:409–416PubMed Lal G, Liu G, Schmocker B, Kaurah P, Ozcelik H, Narod SA, Redston M, Gallinger S (2000) Inherited predisposition to pancreatic adenocarcinoma: role of family history and germ-line p16, BRCA1, and BRCA2 mutations. Cancer Res 60:409–416PubMed
6.
go back to reference Hruban RH, Canto MI, Yeo CJ (2001) Prevention of pancreatic cancer and strategies for management of familial pancreatic cancer. Dig Dis 19:76–84CrossRefPubMed Hruban RH, Canto MI, Yeo CJ (2001) Prevention of pancreatic cancer and strategies for management of familial pancreatic cancer. Dig Dis 19:76–84CrossRefPubMed
7.
go back to reference Brand RE, Lerch MM, Rubinstein WS, Neoptolemos JP, Whitcomb DC, Hruban RH, Brentnall TA, Lynch HT, Canto MI (2007) Participants of the Fourth International Symposium of Inherited Diseases of the P. Advances in counselling and surveillance of patients at risk for pancreatic cancer. Gut 56:1460–1469CrossRefPubMed Brand RE, Lerch MM, Rubinstein WS, Neoptolemos JP, Whitcomb DC, Hruban RH, Brentnall TA, Lynch HT, Canto MI (2007) Participants of the Fourth International Symposium of Inherited Diseases of the P. Advances in counselling and surveillance of patients at risk for pancreatic cancer. Gut 56:1460–1469CrossRefPubMed
8.
go back to reference BCLC (1999) Cancer risks in BRCA2 mutation carriers. The Breast Cancer Linkage Consortium. J Nat Cancer Inst 91:1310–1316 BCLC (1999) Cancer risks in BRCA2 mutation carriers. The Breast Cancer Linkage Consortium. J Nat Cancer Inst 91:1310–1316
9.
go back to reference Vasen HF, Gruis NA, Frants RR, van Der Velden PA, Hille ET, Bergman W (2000) Risk of developing pancreatic cancer in families with familial atypical multiple mole melanoma associated with a specific 19 deletion of p16 (p16-Leiden). Int J Cancer 87:809–811CrossRefPubMed Vasen HF, Gruis NA, Frants RR, van Der Velden PA, Hille ET, Bergman W (2000) Risk of developing pancreatic cancer in families with familial atypical multiple mole melanoma associated with a specific 19 deletion of p16 (p16-Leiden). Int J Cancer 87:809–811CrossRefPubMed
10.
go back to reference Giardiello FM, Brensinger J, Tersmette AC, Goodman SN, Peterson GM, Booker SV, Cruz-Correa M, Offerhaus JA (2000) Very high risk of cancer in familial Peutz-Jeghers syndrome. Gastroenterology 119:1447–1453CrossRefPubMed Giardiello FM, Brensinger J, Tersmette AC, Goodman SN, Peterson GM, Booker SV, Cruz-Correa M, Offerhaus JA (2000) Very high risk of cancer in familial Peutz-Jeghers syndrome. Gastroenterology 119:1447–1453CrossRefPubMed
11.
go back to reference Lowenfels AB, Maisonneuve P, DiMagno EP, Elitsur Y (1997) Hereditary pancreatitis and the risk of pancreatic cancer. J Nat Cancer Inst 89:442–446CrossRefPubMed Lowenfels AB, Maisonneuve P, DiMagno EP, Elitsur Y (1997) Hereditary pancreatitis and the risk of pancreatic cancer. J Nat Cancer Inst 89:442–446CrossRefPubMed
12.
go back to reference Klein AP, Beaty TH, Bailey-Wilson JE, Brune KA, Hruban RH, Petersen GM (2002) Evidence for a major gene influencing risk of pancreatic cancer. Genetic Epidemiol 23:133–149CrossRef Klein AP, Beaty TH, Bailey-Wilson JE, Brune KA, Hruban RH, Petersen GM (2002) Evidence for a major gene influencing risk of pancreatic cancer. Genetic Epidemiol 23:133–149CrossRef
13.
go back to reference Petersen GM, de Andrade M, Goggins M, Hruban RH, Bondy M, Korczak JF, Gallinger S, Lynch HT, Syngal S, Rabe KG, Seminara D, Klein AP (2006) Pancreatic cancer genetic epidemiology consortium. Cancer Epidemiol Biomark Prev 15:704–710CrossRef Petersen GM, de Andrade M, Goggins M, Hruban RH, Bondy M, Korczak JF, Gallinger S, Lynch HT, Syngal S, Rabe KG, Seminara D, Klein AP (2006) Pancreatic cancer genetic epidemiology consortium. Cancer Epidemiol Biomark Prev 15:704–710CrossRef
14.
go back to reference Brentnall TA, Bronner MP, Byrd DR, Haggitt RC, Kimmey MB (1999) Early diagnosis and treatment of pancreatic dysplasia in patients with a family history of pancreatic cancer. [erratum appears in Ann Intern Med 2000 Mar 7;132(5):419]. Ann Intern Med 131:247–255PubMed Brentnall TA, Bronner MP, Byrd DR, Haggitt RC, Kimmey MB (1999) Early diagnosis and treatment of pancreatic dysplasia in patients with a family history of pancreatic cancer. [erratum appears in Ann Intern Med 2000 Mar 7;132(5):419]. Ann Intern Med 131:247–255PubMed
15.
go back to reference Kimmey MB, Bronner MP, Byrd DR, Brentnall TA (2002) Screening and surveillance for hereditary pancreatic cancer. Gastrointest Endoscopy 56:S82–S86CrossRef Kimmey MB, Bronner MP, Byrd DR, Brentnall TA (2002) Screening and surveillance for hereditary pancreatic cancer. Gastrointest Endoscopy 56:S82–S86CrossRef
16.
go back to reference Canto MI, Goggins M, Yeo CJ, Griffin C, Axilbund JE, Brune K, Ali SZ, Jagannath S, Petersen GM, Fishman EK, Piantadosi S, Giardiello FM, Hruban RH (2004) Screening for pancreatic neoplasia in high-risk individuals: an EUS-based approach. Clin Gastroenterol Hepatol 2:606–621CrossRefPubMed Canto MI, Goggins M, Yeo CJ, Griffin C, Axilbund JE, Brune K, Ali SZ, Jagannath S, Petersen GM, Fishman EK, Piantadosi S, Giardiello FM, Hruban RH (2004) Screening for pancreatic neoplasia in high-risk individuals: an EUS-based approach. Clin Gastroenterol Hepatol 2:606–621CrossRefPubMed
17.
go back to reference Canto MI, Goggins M, Hruban RH, Petersen GM, Giardiello FM, Yeo C, Fishman EK, Brune K, Axilbund J, Griffin C, Ali S, Richman J, Jagannath S, Kantsevoy SV, Kalloo AN (2006) Screening for early pancreatic neoplasia in high-risk individuals: a prospective controlled study. [see comment]. Clin Gastroenterol Hepatol 4:766–781; quiz 665 Canto MI, Goggins M, Hruban RH, Petersen GM, Giardiello FM, Yeo C, Fishman EK, Brune K, Axilbund J, Griffin C, Ali S, Richman J, Jagannath S, Kantsevoy SV, Kalloo AN (2006) Screening for early pancreatic neoplasia in high-risk individuals: a prospective controlled study. [see comment]. Clin Gastroenterol Hepatol 4:766–781; quiz 665
18.
go back to reference Rulyak SJ, Brentnall TA (2001) Inherited pancreatic cancer: surveillance and treatment strategies for affected families. Pancreatology 1:477–485CrossRefPubMed Rulyak SJ, Brentnall TA (2001) Inherited pancreatic cancer: surveillance and treatment strategies for affected families. Pancreatology 1:477–485CrossRefPubMed
19.
go back to reference Wardle J, Williamson S, Sutton S, Biran A, McCaffery K, Cuzick J, Atkin W (2003) Psychological impact of colorectal cancer screening. Health Psychol 22:54–59CrossRefPubMed Wardle J, Williamson S, Sutton S, Biran A, McCaffery K, Cuzick J, Atkin W (2003) Psychological impact of colorectal cancer screening. Health Psychol 22:54–59CrossRefPubMed
20.
go back to reference Absetz P, Aro AR, Sutton SR (2003) Experience with breast cancer, pre-screening perceived susceptibility and the psychological impact of screening. Psycho-Oncology 12:305–318CrossRefPubMed Absetz P, Aro AR, Sutton SR (2003) Experience with breast cancer, pre-screening perceived susceptibility and the psychological impact of screening. Psycho-Oncology 12:305–318CrossRefPubMed
21.
go back to reference Andersen MR, Drescher CW, Zheng Y, Bowen DJ, Wilson S, Young A, McIntosh M, Mahony BS, Lowe KA, Urban N (2007) Changes in cancer worry associated with participation in ovarian cancer screening. Psycho-Oncology 16:814–820CrossRefPubMed Andersen MR, Drescher CW, Zheng Y, Bowen DJ, Wilson S, Young A, McIntosh M, Mahony BS, Lowe KA, Urban N (2007) Changes in cancer worry associated with participation in ovarian cancer screening. Psycho-Oncology 16:814–820CrossRefPubMed
22.
go back to reference Bish A, Sutton S, Jacobs C, Levene S, Ramirez A, Hodgson S (2002) Changes in psychological distress after cancer genetic counselling: a comparison of affected and unaffected women. Br J Cancer 86:43–50CrossRefPubMed Bish A, Sutton S, Jacobs C, Levene S, Ramirez A, Hodgson S (2002) Changes in psychological distress after cancer genetic counselling: a comparison of affected and unaffected women. Br J Cancer 86:43–50CrossRefPubMed
23.
go back to reference Watson EK, Henderson BJ, Brett J, Bankhead C, Austoker J (2005) The psychological impact of mammographic screening on women with a family history of breast cancer—a systematic review. Psycho-Oncology 14:939–948CrossRefPubMed Watson EK, Henderson BJ, Brett J, Bankhead C, Austoker J (2005) The psychological impact of mammographic screening on women with a family history of breast cancer—a systematic review. Psycho-Oncology 14:939–948CrossRefPubMed
24.
go back to reference Brett J, Bankhead C, Henderson B, Watson E, Austoker J (2005) The psychological impact of mammographic screening. A systematic review. Psycho-Oncology 14:917–938CrossRefPubMed Brett J, Bankhead C, Henderson B, Watson E, Austoker J (2005) The psychological impact of mammographic screening. A systematic review. Psycho-Oncology 14:917–938CrossRefPubMed
25.
go back to reference Lindfors KK, O’Connor J, Parker RA (2001) False-positive screening mammograms: effect of immediate versus later work-up on patient stress. Radiology 218:247–253PubMed Lindfors KK, O’Connor J, Parker RA (2001) False-positive screening mammograms: effect of immediate versus later work-up on patient stress. Radiology 218:247–253PubMed
26.
go back to reference Halbert C, Kessler L, Collier A, Paul Wileyto E, Brewster K, Weathers B (2005) Psychological functioning in African American women at an increased risk of hereditary breast and ovarian cancer. Clin Genet 68:222–227CrossRefPubMed Halbert C, Kessler L, Collier A, Paul Wileyto E, Brewster K, Weathers B (2005) Psychological functioning in African American women at an increased risk of hereditary breast and ovarian cancer. Clin Genet 68:222–227CrossRefPubMed
27.
go back to reference Costanzo ES, Lutgendorf SK, Mattes ML, Trehan S, Robinson CB, Tewfik F, Roman SL (2007) Adjusting to life after treatment: distress and quality of life following treatment for breast cancer. Br J Cancer 97:1625–1631CrossRefPubMed Costanzo ES, Lutgendorf SK, Mattes ML, Trehan S, Robinson CB, Tewfik F, Roman SL (2007) Adjusting to life after treatment: distress and quality of life following treatment for breast cancer. Br J Cancer 97:1625–1631CrossRefPubMed
28.
go back to reference Erlick Robinson G, Rosen BP, Bradley LN, Rockert WG, Carr ML, Cole DE, Murphy KJ (1997) Psychological impact of screening for familial ovarian cancer: reactions to initial assessment.[see comment]. Gynecol Oncol 65:197–205CrossRefPubMed Erlick Robinson G, Rosen BP, Bradley LN, Rockert WG, Carr ML, Cole DE, Murphy KJ (1997) Psychological impact of screening for familial ovarian cancer: reactions to initial assessment.[see comment]. Gynecol Oncol 65:197–205CrossRefPubMed
29.
go back to reference McCaffery K, Waller J, Nazroo J, Wardle J (2006) Social and psychological impact of HPV testing in cervical screening: a qualitative study. Sex Transm Infect 82:169–174CrossRefPubMed McCaffery K, Waller J, Nazroo J, Wardle J (2006) Social and psychological impact of HPV testing in cervical screening: a qualitative study. Sex Transm Infect 82:169–174CrossRefPubMed
30.
go back to reference Kimmey M, Bronner M, Byrd D, Brentnall T (2002) Screening and surveillance for hereditary pancreatic cancer. Gastrointest Endosc 56:S82–S86CrossRefPubMed Kimmey M, Bronner M, Byrd D, Brentnall T (2002) Screening and surveillance for hereditary pancreatic cancer. Gastrointest Endosc 56:S82–S86CrossRefPubMed
31.
go back to reference Collins V, Halliday J, Warren R, Williamson R (2000) Cancer worries, risk perceptions and associations with interest in DNA testing and clinic satisfaction in a familial colorectal cancer clinic. Clin Genet 58:460–468CrossRefPubMed Collins V, Halliday J, Warren R, Williamson R (2000) Cancer worries, risk perceptions and associations with interest in DNA testing and clinic satisfaction in a familial colorectal cancer clinic. Clin Genet 58:460–468CrossRefPubMed
32.
go back to reference Brain K, Henderson BJ, Tyndel S, Bankhead E, Watson A, Clements A, Austoker J (2008) Predictors of breast cancer-related distress following mammography screening in younger women on a family history breast screening programme. Psycho-Oncology 1057–9249 (in press) Brain K, Henderson BJ, Tyndel S, Bankhead E, Watson A, Clements A, Austoker J (2008) Predictors of breast cancer-related distress following mammography screening in younger women on a family history breast screening programme. Psycho-Oncology 1057–9249 (in press)
33.
go back to reference CCS. Canadian Cancer Statitics 2009. In: Canada CCSNCIo (ed) Canadian Cancer Society, 2009 CCS. Canadian Cancer Statitics 2009. In: Canada CCSNCIo (ed) Canadian Cancer Society, 2009
34.
go back to reference van Dijk S, Otten W, Zoeteweij MW, Timmermans DRM, van Asperen CJ, Breuning MH, Tollenaar RA, Kievit J (2003) Genetic counselling and the intention to undergo prophylactic mastectomy: effects of a breast cancer risk assessment. Br J Cancer 88:1675–1681 van Dijk S, Otten W, Zoeteweij MW, Timmermans DRM, van Asperen CJ, Breuning MH, Tollenaar RA, Kievit J (2003) Genetic counselling and the intention to undergo prophylactic mastectomy: effects of a breast cancer risk assessment. Br J Cancer 88:1675–1681
35.
go back to reference Lerman C, Trock B, Rimer BK, Jepson C, Brody D, Boyce A (1991) Psychological side effects of breast cancer screening. Health Psychol 10:259–267CrossRefPubMed Lerman C, Trock B, Rimer BK, Jepson C, Brody D, Boyce A (1991) Psychological side effects of breast cancer screening. Health Psychol 10:259–267CrossRefPubMed
36.
go back to reference Derogatis LR, Melisaratos N (1983) The Brief Symptom Inventory: an introductory report. Psychol Med 13:595–605CrossRefPubMed Derogatis LR, Melisaratos N (1983) The Brief Symptom Inventory: an introductory report. Psychol Med 13:595–605CrossRefPubMed
37.
go back to reference Hjörleifsdóttir EHIR, Bolmsjö IA, Gunnarsdóttir ED (2006) Distress and coping in cancer patients: feasibility of the Icelandic version of BSI 18 and the WOC-CA questionnaires. Eur J Cancer Care 15:80–89CrossRef Hjörleifsdóttir EHIR, Bolmsjö IA, Gunnarsdóttir ED (2006) Distress and coping in cancer patients: feasibility of the Icelandic version of BSI 18 and the WOC-CA questionnaires. Eur J Cancer Care 15:80–89CrossRef
38.
go back to reference Croyle RT, Lerman C (1999) Risk communication in genetic testing for cancer susceptibility. J Nat Cancer Inst. Monographs 59–66 Croyle RT, Lerman C (1999) Risk communication in genetic testing for cancer susceptibility. J Nat Cancer Inst. Monographs 59–66
39.
go back to reference Axilbund JE, Brune KA, Canto MI, Brehon BC, Wroblewski LD, Griffin CA (2005) Patient perspective on the value of genetic counselling for familial pancreas cancer. Hered Cancer Clin Pract 3:115–122PubMed Axilbund JE, Brune KA, Canto MI, Brehon BC, Wroblewski LD, Griffin CA (2005) Patient perspective on the value of genetic counselling for familial pancreas cancer. Hered Cancer Clin Pract 3:115–122PubMed
40.
go back to reference Wang W, Chen S, Brune KA, Hruban RH, Parmigiani G, Klein AP (2007) PancPRO: risk assessment for individuals with a family history of pancreatic cancer. J Clin Oncol 25:1417–1422CrossRefPubMed Wang W, Chen S, Brune KA, Hruban RH, Parmigiani G, Klein AP (2007) PancPRO: risk assessment for individuals with a family history of pancreatic cancer. J Clin Oncol 25:1417–1422CrossRefPubMed
Metadata
Title
Pancreatic cancer risk counselling and screening: impact on perceived risk and psychological functioning
Authors
Christine Maheu
Andrea Vodermaier
Heidi Rothenmund
Steve Gallinger
Paola Ardiles
Kara Semotiuk
Spring Holter
Saumea Thayalan
Mary Jane Esplen
Publication date
01-12-2010
Publisher
Springer Netherlands
Published in
Familial Cancer / Issue 4/2010
Print ISSN: 1389-9600
Electronic ISSN: 1573-7292
DOI
https://doi.org/10.1007/s10689-010-9354-5

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