Genetic testing in a population-based sample of breast and ovarian cancer survivors from the REACH randomized trial: Cost barriers and moderators o... - PubMed - NCBI
Genetic testing in a population-based sample of breast and ovarian cancer survivors from the REACH randomized trial: Cost barriers and moderators of counseling mode.
Steffen LE1,
Du R2,
Gammon A3,
Mandelblatt JS4,
Kohlmann WK3,
Lee JH2,
Buys SS5,
Stroup AM6,
Campo RA7,
Flores KG8,
Vicuña B9,
Schwartz MD10,
Kinney AY11.
Abstract
BACKGROUND:
This study evaluates predictors of BRCA1/2 testing among breast and ovarian cancer survivors who received genetic counseling as part of a randomized trial and evaluates moderators of counseling mode on testing uptake. METHODS:
Predictors of BRCA1/2 testing within 1-year post-counseling were evaluated using multivariable logistic regression in a population-based sample of breast and ovarian cancer survivors at increased hereditary risk randomly assigned to in-person (IPC; n = 379) vs. telephone counseling (TC; n = 402). Variables that moderated the association between counseling mode and testing were identified by subgroup analysis. RESULTS:
Testing uptake was associated with higher perceived comparative mutation risk (OR = 1.32, 95% CI = 1.11, 1.57) in the adjusted analysis. Those without cost barriers had higher testing uptake (OR = 18.73, 95% CI = 7.09, 49.46). Psychological distress and perceived comparative mutation risk moderated the effect of counseling and testing. Uptake between IPC vs. TC did not differ at low levels of distress and risk, but differed at high distress (26.3% TC vs. 44.3% IPC) and high perceived comparative risk (33.9% TC vs. 50.5% IPC). CONCLUSIONS:
Cost concerns are a strong determinant of testing. Differences in testing uptake by counseling mode may depend on pre-counseling distress and risk perceptions. IMPACT:
Cost concerns may contribute to low testing in population-based samples of at risk cancer survivors. Pre-counseling psychosocial characteristics should be considered when offering in-person vs. telephone counseling. Copyright ©2017, American Association for Cancer Research.
No hay comentarios:
Publicar un comentario