Dataset Information

Understanding of multigene test results among males undergoing germline testing for inherited prostate cancer: Implications for genetic counseling.

ABSTRACT: BACKGROUND:Genetic testing (GT) for prostate cancer (PCA) is rising, with limited insights regarding genetic counseling (GC) needs of males. Genetic Evaluation of Men (GEM) is a prospective multigene testing study for inherited PCA. Men undergoing GC were surveyed on knowledge of cancer risk and genetics (CRG) and understanding of personal GT results to identify GC needs. METHODS:GEM participants with or high-risk for PCA were recruited. Pre-test GC was in-person, with video and handout, or via telehealth. Post-test disclosure was in-person, by phone, or via telehealth. Clinical and family history data were obtained from participant surveys and medical records. Participants completed measures of knowledge of CRG, literacy, and numeracy pre-test and post-test. Understanding of personal genetic results was assessed post-test. Factors associated with knowledge of CRG and understanding of personal genetic results were examined using multivariable linear regression or McNemar's test. RESULTS:Among 109 men who completed pre- and post-GT surveys, multivariable analysis revealed family history meeting hereditary cancer syndrome (HCS) criteria was significantly predictive of higher baseline knowledge (P?=?0.040). Of 101 men who responded definitively regarding understanding of results, 13 incorrectly reported their result (McNemar's P?

SUBMITTER: Giri VN

PROVIDER: S-EPMC6047906 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Understanding of multigene test results among males undergoing germline testing for inherited prostate cancer: Implications for genetic counseling.

Giri Veda N VN Obeid Elias E Hegarty Sarah E SE Gross Laura L Bealin Lisa L Hyatt Colette C Fang Carolyn Y CY Leader Amy A

The Prostate 20180414 12

<h4>Background</h4>Genetic testing (GT) for prostate cancer (PCA) is rising, with limited insights regarding genetic counseling (GC) needs of males. Genetic Evaluation of Men (GEM) is a prospective multigene testing study for inherited PCA. Men undergoing GC were surveyed on knowledge of cancer risk and genetics (CRG) and understanding of personal GT results to identify GC needs.<h4>Methods</h4>GEM participants with or high-risk for PCA were recruited. Pre-test GC was in-person, with video and h ...[more]

PMID: 29655297

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Project description:BackgroundGenetic counseling (GC) and genetic testing (GT) for prostate cancer (PCA) is a rapidly growing, affording opportunity for healthy lifestyle promotion in men aligned with cancer survivorship and cancer prevention goals. We conducted a targeted dietary analysis of men undergoing GC/GT for PCA for adherence to the United States Department of Agriculture (USDA) Food Pattern recommendations which align with preventing cancer and recurrences in the Genetic Evaluation of Men (GEM) study at two academic centers to inform future strategies for diet intervention.MethodsParticipants of GEM with PCA or at-risk for PCA completed a structured food frequency questionnaire indicating number of servings consumed per day or per week of fruits, vegetables, red meat, seafood, processed meat, and foods high in saturated fat. Adherence to the USDA recommendations was assessed for the total sample and by PCA status and aggressiveness, family history, and body mass index (BMI) through χ 2 contingency analyses. One-sample t tests were used to compare the dietary behaviors of men to USDA Recommendations. Levels of α were set a priori at P < 0.05.ResultsOf 239 males undergoing GC on the study, surveys were completed by 197 men (82.4%), and complete survey data was available on 113 men (47.3%). By the Centers for Disease Control and Prevention BMI classification, 82.3% of the cohort was overweight (45.1%) or obese (37.2%). GEM participants reported consuming less fruits (P = 0.015), less vegetables ( P < 0.001), less seafood ( P < 0.001), more processed meats ( P < 0.001), and more foods high in saturated fats ( P < 0.001) than recommended.ConclusionA high proportion of men receiving GC/GT for PCA were overweight and/or obese with lack of adherence to national diet recommendations for cancer risk and recurrence, affording a teachable moment and supporting the systematic focus of introducing nutrition intervention during GC to promote survivorship.

Project description:BackgroundGermline genetic testing is a vital component of guideline-recommended cancer care for males with pancreatic, breast, or metastatic prostate cancers. We sought to determine whether there were racial disparities in germline genetic testing completion in this population.Patients and methodsThis retrospective cohort study included non-Hispanic White and Black males with incident pancreatic, breast, or metastatic prostate cancers between January 1, 2019, and September 30, 2021. Two nationwide cohorts were examined: (1) commercially insured individuals in an administrative claims database, and (2) Veterans receiving care in the Veterans Health Administration. One-year germline genetic testing rates were estimated by using Kaplan-Meier methods. Cox proportional hazards regression was used to test the association between race and genetic testing completion. Causal mediation analyses were performed to investigate whether socioeconomic variables contributed to associations between race and germline testing.ResultsOur cohort consisted of 7,894 males (5,142 commercially insured; 2,752 Veterans). One-year testing rates were 18.0% (95% CI, 16.8%-19.2%) in commercially insured individuals and 14.2% (95% CI, 11.5%-15.0%) in Veterans. Black race was associated with a lower hazard of testing among commercially insured individuals (adjusted hazard ratio [aHR], 0.73; 95% CI, 0.58-0.91; P=.005) but not among Veterans (aHR, 0.99; 95% CI, 0.75-1.32; P=.960). In commercially insured individuals, income (aHR, 0.90; 95% CI, 0.86-0.96) and net worth (aHR, 0.92; 95% CI, 0.86-0.98) mediated racial disparities, whereas education (aHR, 0.98; 95% CI, 0.94-1.01) did not.ConclusionsOverall rates of guideline-recommended genetic testing are low in males with pancreatic, breast, or metastatic prostate cancers. Racial disparities in genetic testing among males exist in a commercially insured population, mediated by net worth and household income; these disparities are not seen in the equal-access Veterans Health Administration. Alleviating financial and access barriers may mitigate racial disparities in genetic testing.

Dataset Information

Understanding of multigene test results among males undergoing germline testing for inherited prostate cancer: Implications for genetic counseling.

Publications

Understanding of multigene test results among males undergoing germline testing for inherited prostate cancer: Implications for genetic counseling.

Similar Datasets

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