A sociobehavioural perspective on genetic testing and counselling for heritable breast, ovarian and colon cancer
Kathleen G. Macdonald,* RN, PhD; Brian Doan,** PhD; Merrijoy Kelner,# PhD; Kathryn M. Taylor,& PhD
Canadian Medical Association Journal 1996; 154: 457-464
From *the departments of Administrative Studies and Nursing, York University, North York, Ont., **Psychology Services to Oncology, Sunnybrook Health Science Centre, #the Department of Behavioural Science and the Centre for Studies of Aging, University of Toronto, Toronto, Ont., and &the Department of Administrative Studies, York University, North York, and Princess Margaret Hospital, Toronto, Ont.
This is the second in a series on genetic screening for heritable breast, ovarian and colon cancer. The first article [abstract] appeared in the Jan. 15, 1996, issue and the third article [abstract] appears in the Mar. 15 issue.
Paper reprints of the full text may be obtained from: Dr. Kathleen G. Macdonald, Department of Administrative Studies, Atkinson College, York University, 4700 Keele St., North York ON M3J 1P3; fax 416 736-5210; kathem@yorku.ca
Abstract
Testing for susceptibility to heritable breast, ovarian and colon cancer has unique psychosocial costs. Negative test results may not be sufficient to relieve anxiety, and positive results can cause sufficient distress to compromise patient compliance with surveillance and risk reduction measures. More needs to be learned about how sociocultural factors affect the understanding of risk, how decisions to undergo testing are made and how information about increased risk affects family dynamics. As the demand for testing and counselling grows, health care providers will be faced with new challenges and dilemmas. A better understanding of genetics by the public is needed to mitigate deterministic attitudes that can lead to the neglect of health promotion. Also of concern are the socioeconomic implications of being identified as having a high risk for heritable cancer and the dangers inherent in using genetics to explain sociological phenomena. Health care providers must take the lead in ensuring that developments in genetics are used to the benefit of all.
| CMAJ February 15, 1996 (vol 154, no 4) |