Illustrating cancer risk: Patient risk communication preferences and interest regarding a novel BRCA1/2 genetic risk modifier test Journal Article


Authors: Hamilton, J. G.; Genoff Garzon, M.; Shah, I. H.; Cadet, K.; Shuk, E.; Westerman, J. S.; Hay, J. L.; Offit, K.; Robson, M. E.
Article Title: Illustrating cancer risk: Patient risk communication preferences and interest regarding a novel BRCA1/2 genetic risk modifier test
Abstract: Introduction: Genetic risk modifier testing (GRMT), an emerging form of genetic testing based on common single nucleotide polymorphisms and polygenic risk scores, has the potential to refine estimates of BRCA1/2 mutation carriers' breast cancer risks. However, for women to benefit from GRMT, effective approaches for communicating this novel risk information are needed. Objective: To evaluate patient preferences regarding risk communication materials for GRMT. Methods: We developed four separate presentations (panel of genes, icon array, verbal risk estimate, graphical risk estimate) of hypothetical GRMT results, each using varying risk communication strategies to convey different information elements including number of risk modifier variants present, variant prevalence among BRCA1/2 carriers, and implications and uncertainties of test results for cancer risk. Thirty BRCA1/2 carriers evaluated these materials (randomized to low, moderate, or high breast cancer risk versions). Qualitative and quantitative data were obtained through in-person interviews. Results: Across risk versions, participants preferred the presentation of the graphical risk estimate, often in combination with the verbal risk estimate. Interest in GRMT was high; 76.7% of participants wanted their own GRMT. Participants valued the potential for GRMT to clarify their cancer susceptibility and provide actionable information. Many (65.5%) anticipated that GRMT would make risk management decisions easier. Conclusions: Women with BRCA1/2 mutations could be highly receptive to GRMT, and the minimal amount of necessary information to be included in result risk communication materials includes graphical and verbal estimates of future cancer risk. Findings will inform clinical translation of GRMT in a manner consistent with patients' preferences. © 2020 S. Karger AG, Basel. Copyright: All rights reserved.
Keywords: adult; clinical article; aged; cancer risk; cancer patient; cancer susceptibility; breast cancer; prevalence; genetic variability; brca1 protein; brca2 protein; heterozygote; high risk patient; cancer genetics; medical information; genetic susceptibility; clinical evaluation; information dissemination; interpersonal communication; patient decision making; genetic screening; patient attitude; qualitative research; genetic testing; semi structured interview; risk management; quantitative study; patient preference; content analysis; thematic analysis; risk communication; hereditary breast and ovarian cancer; qualitative methods; human; female; priority journal; article; polygenic risk score; patient risk; genetic risk score; constructive feedback; genetic risk modifier testing
Journal Title: Public Health Genomics
Volume: 23
Issue: 1-2
ISSN: 1662-4246
Publisher: S. Karger AG  
Date Published: 2020-01-01
Start Page: 6
End Page: 19
Language: English
DOI: 10.1159/000505854
PUBMED: 32191943
PROVIDER: scopus
PMCID: PMC7272266
DOI/URL:
Notes: Article -- Export Date: 1 July 2020 -- Source: Scopus
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MSK Authors
  1. Kenneth Offit
    790 Offit
  2. Mark E Robson
    681 Robson
  3. Jennifer L Hay
    267 Hay
  4. Elyse Shuk
    62 Shuk
  5. Margaux Christine Genoff
    24 Genoff
  6. Jada Gabrielle Hamilton
    113 Hamilton
  7. Kechna Cadet
    3 Cadet
  8. Ibrahim Hussein Shah
    8 Shah