Online self-test identifies women at high familial breast cancer risk in population-based breast cancer screening without inducing anxiety or distress.

van Erkelens A1, Sie AS1, Manders P2, Visser A3, Duijm LE4, Mann RM5, Ten Voorde M6, Kroeze H6, Prins JB3, Hoogerbrugge N7.

Author information

Abstract

INTRODUCTION:

Identifying high familial breast cancer (FBC) risk improves detection of yet unknown BRCA1/2-mutation carriers, for whom BC risk is both highly likely and potentially preventable. We assessed whether a new online self-test could identify women at high FBC risk in population-based BC screening without inducing anxiety or distress.

METHODS:

After their visit for screening mammography, women were invited by email to take an online self-test for identifying highly increased FBC risk-based on Dutch guidelines. Exclusion criteria were previously diagnosed as increased FBC risk or a personal history of BC. Anxiety (State-Trait Anxiety Inventory Dutch Version), distress (Hospital Anxiety Depression Scale) and BC risk perception were assessed using questionnaires, which were completed immediately before and after taking the online self-test and 2 weeks later.

RESULTS:

Of the 562 women invited by email, 406 (72%) completed the online self-test while 304 also completed questionnaires (response rate 54%). After exclusion criteria, 287 (51%) were included for data analysis. Median age was 56 years (range 50-74). A high or moderate FBC risk was identified in 12 (4%) and three (1%) women, respectively. After completion of the online self-test, anxiety and BC risk perception were decreased while distress scores remained unchanged. Levels were below clinical relevance. Most women (85%) would recommend the self-test; few (3%) would not.

CONCLUSION:

The online self-test identified previously unknown women at high FBC risk (4%), who may carry a BRCA1/2-mutation, without inducing anxiety or distress. We therefore recommend offering this self-test to women who attend population-based screening mammography for the first time.

KEYWORDS:

BRCA1; BRCA2; Breast cancer; Distress; Familial risk assessment; Genetic counselling; Hereditary; Population screening; Prevention; Risk

PMID:: 28412588
DOI:: 10.1016/j.ejca.2017.03.014

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