How Much Information Do Icelandic Men Receive on Pros and Cons of Prostate-Specific Antigen Testing Prior to Undergoing Testing?

Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Traditional Chinese Medical Science and Technology Project of Zhejiang Province (Grant No. 2022ZB130), and the National Famous Old Chinese Medicine Experts SONG Xinwei Inheritance Studio Project (G.TCM.R.J.H.[2018]134). Funding Information: The authors acknowledge the important work done at the Icelandic Cancer Registry that made this study possible and thank their staff for invaluable guidance. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Icelandic Center for Research (grant no. 141490) and the Research Fund of the Icelandic Cancer Society (grant no. 2017-05). Publisher Copyright: © The Author(s) 2022.Prostate-specific antigen (PSA) testing for asymptomatic men is neither encouraged nor discouraged in most countries; however, shared decision-making is emphasized prior to PSA testing. The objective of this study was to examine to what extent Icelandic men receive information about the pros and cons of PSA testing. Furthermore, to explore if patient–provider communication about pros and cons of PSA testing has improved in the last decade during which time more emphasis has been placed on shared decision-making. All Icelandic men diagnosed with prostate cancer in the years 2015 to 2020 were invited to participate, and a total of 471 out of 1002 men participated (response rate 47.0%). Participants’ age ranged from 51 to 95 years (M = 71.9, SD = 7.3). Only half of the men received information about the pros and cons of PSA testing, a third did not receive any information prior to testing and, alarmingly, 22.2% of the men did not even know that they were being tested. A majority of the participants lacked knowledge about the testing with half of the men reporting that they had no knowledge about pros and cons of PSA testing prior to testing. The findings have major public health relevance as they indicate that information provided prior to PSA testing continue to be deficient and that there is a pressing need for interventions that educate men about the benefits and limitations of PSA testing before men undergo medical procedures that can seriously affect their quality of life.Peer reviewe

Conducting Molecular Epidemiological Research in the Age of HIPAA: A Multi-Institutional Case-Control Study of Breast Cancer in African-American and European-American Women

Breast cancer in African-American (AA) women occurs at an earlier age than in European-American (EA) women and is more likely to have aggressive features associated with poorer prognosis, such as high-grade and negative estrogen receptor (ER) status. The mechanisms underlying these differences are unknown. To address this, we conducted a case-control study to evaluate risk factors for high-grade ER- disease in both AA and EA women. With the onset of the Health Insurance Portability and Accountability Act of 1996, creative measures were needed to adapt case ascertainment and contact procedures to this new environment of patient privacy. In this paper, we report on our approach to establishing a multicenter study of breast cancer in New York and New Jersey, provide preliminary distributions of demographic and pathologic characteristics among case and control participants by race, and contrast participation rates by approaches to case ascertainment, with discussion of strengths and weaknesses

Behavioral and psychosocial effects of rapid genetic counseling and testing in newly diagnosed breast cancer patients: Design of a multicenter randomized clinical trial

<p>Abstract</p> <p>Background</p> <p>It has been estimated that between 5% and 10% of women diagnosed with breast cancer have a hereditary form of the disease, primarily caused by a <it>BRCA1 </it>or <it>BRCA2 </it>gene mutation. Such women have an increased risk of developing a new primary breast and/or ovarian tumor, and may therefore opt for preventive surgery (e.g., bilateral mastectomy, oophorectomy). It is common practice to offer high-risk patients genetic counseling and DNA testing after their primary treatment, with genetic test results being available within 4-6 months. However, some non-commercial laboratories can currently generate test results within 3 to 6 weeks, and thus make it possible to provide <it>rapid </it>genetic counseling and testing (RGCT) prior to primary treatment. The aim of this study is to determine the effect of RGCT on treatment decisions and on psychosocial health.</p> <p>Methods/Design</p> <p>In this randomized controlled trial, 255 newly diagnosed breast cancer patients with at least a 10% risk of carrying a <it>BRCA </it>gene mutation are being recruited from 12 hospitals in the Netherlands. Participants are randomized in a 2:1 ratio to either a RGCT intervention group (the offer of RGCT directly following diagnosis with tests results available before surgical treatment) or to a usual care control group. The primary behavioral outcome is the uptake of direct bilateral mastectomy or delayed prophylactic contralateral mastectomy. Psychosocial outcomes include cancer risk perception, cancer-related worry and distress, health-related quality of life, decisional satisfaction and the perceived need for and use of additional decisional counseling and psychosocial support. Data are collected via medical chart audits and self-report questionnaires administered prior to randomization, and at 6 month and at 12 month follow-up.</p> <p>Discussion</p> <p>This trial will provide essential information on the impact of RGCT on the choice of primary surgical treatment among women with breast cancer with an increased risk of hereditary cancer. This study will also provide data on the psychosocial consequences of RGCT and of risk-reducing behavior.</p> <p>Trial registration</p> <p>The study is registered at the Netherlands Trial Register (NTR1493) and ClinicalTrials.gov (NCT00783822).</p

Family histories of breast cancer, coping styles, and psychological adjustment

Although women with family histories of breast cancer (FHBC+) have been reported to have higher levels of cancer-specific and general distress than have women without such histories (FHBC-), there has been considerable variability in levels of distress found. This study examined individual differences in the use of coping strategies as likely moderators of the relationship between FHBC and psychological outcomes. One hundred and sixteen healthy women (47 FHBC+ and 69 FHBC-) participated. Results revealed that passive coping style was associated with higher levels of cancer-specific distress among FHBC+, but not among FHBC-. This interaction was not found for negative or positive affect. The passive coping style was associated with higher levels of negative affect across both groups. These results suggest that passive coping has negative implications for FHBC+ women and imply that individualized coping training programs targeting this coping strategy may prove useful for these women

Psychological distress among healthy women with family histories of breast cancer: effects of recent life events

The experience of breast cancer in a close family member can be a major life stressor for many women as evidenced by various psychosocial and biological indicators. However, existing studies have found considerable variability in the levels of psychological distress among women with family histories of breast cancer (FHBC). Based on cognitive processing models, we examined moderating effects of recent life events on the impact of having a family member with breast cancer and psychological distress. Specifically, we hypothesized that negative recent life events would be associated with greater psychological distress and that positive recent life events would be associated with less psychological distress, and these patterns will be more prominent among women with FHBC than women without FHBC. Women with (FHBC+, N = 59) and women without (FHBC-, N = 94) FHBC completed measures of recent life events, cancer-specific distress (intrusion and avoidance) and general distress. Results indicated that among FHBC+ women, negative life events were associated with higher levels of breast cancer-specific intrusion and positive life events were associated with lower levels of breast cancer-specific avoidance. These results support the application of cognitive processing models for understanding variability in women's psychological adjustment to their FHBC. Psychological interventions designed to facilitate coping with negative life events and to increase the occurrence of positive events may be warranted