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Randomized trial of a specialist genetic assessment service for familial breast cancer

Brain, Katherine Emma, Gray, Jonathon, Norman, Paul, France, Elizabeth, Anglim, Cathy, Barton, Garry, Parsons, Evelyn Patricia, Clarke, Alan Richard, Sweetland, Helen Margaret, Tischkowitz, Marc, Myring, Jenny, Stansfield, Kate, Webster, David, Gower-Thomas, Kate, Daoud, Raouf, Gateley, Chris, Montpenny, Ian, Singhal, Hemant, Branston, Lucy, Sampson, Julian Roy, Roberts, Elizabeth, Newcombe, Robert Gordon, Cohen, David, Rogers, Cerilan, Mansel, Robert Edward and Harper, Peter Stanley 2000. Randomized trial of a specialist genetic assessment service for familial breast cancer. Journal of the National Cancer Institute 92 (16) , pp. 1345-1351. 10.1093/jnci/92.16.1345

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Abstract

BACKGROUND: Because of the growing demand for genetic assessment, there is an urgent need for information about what services are appropriate for women with a family history of breast cancer. Our purpose was to compare the psychologic impact and costs of a multidisciplinary genetic and surgical assessment service with those of current service provisions. METHODS: We carried out a prospective randomized trial of surgical consultation with (the trial group) and without (the control group) genetic assessment in 1000 women with a family history of breast cancer. All P: values are from two-sided tests. RESULTS: Although statistically significantly greater improvement in knowledge about breast cancer was found in the trial group (P: =.05), differences between groups in other psychologic outcomes were not statistically significant. Women in both groups experienced statistically significant reductions in anxiety and found attending the clinics to be highly satisfying. An initial specialist genetic assessment cost pound 14.27 (U.S. $22.55) more than a consultation with a breast surgeon. Counseling and genetic testing of affected relatives, plus subsequent testing of family members of affected relatives identified as mutation carriers, raised the total extra direct and indirect costs per woman in the trial group to pound 60.98 (U.S. $96.35) over costs for the control subjects. CONCLUSIONS: There may be little benefit in providing specialist genetics services to all women with a family history of breast cancer. Further investigation of factors that may mediate the impact of genetic assessment is in progress and may reveal subgroups of women who would benefit from specialist genetics services.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Biosciences
European Cancer Stem Cell Research Institute (ECSCRI)
Subjects: Q Science > QH Natural history > QH426 Genetics
R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Uncontrolled Keywords: Adult,Anxiety/etiology,Breast Neoplasms/economics*,Breast Neoplasms/genetics,Breast Neoplasms/psychology*,Cost-Benefit Analysis,Female,Genetic Testing/economics*,Humans,Middle Aged,Patient Care Team/economics*,Patient Satisfaction,Prospective Studies,Risk,Wales
Additional Information: Publication Types Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't Full Text Sources HighWire EBSCO Ovid Technologies, Inc. Other Literature Sources COS Scholar Universe Labome Researcher Resource - ExactAntigen/Labome Medical Breast Cancer - MedlinePlus Health Information Genetic Testing - MedlinePlus Health Information Miscellaneous NCI CPTC Antibody Characterization Program
Publisher: Oxford University Press
ISSN: 0027-8874
Related URLs:
Last Modified: 16 Nov 2018 20:48
URI: http://orca-mwe.cf.ac.uk/id/eprint/58286

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