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Senior Citizen Health & Medicine
Genetic Breast Cancer Assessment Eases Stress for
Women at Risk
Demand leads to opening of genetic cancer clinics
April 18, 2007 - Since recent medical findings have
revealed that some families have increased breast cancer risk, a number
of people are turning to cancer genetic services to learn more. Most
often they leave satisfied and with less stress and worry about getting
the disease, according to a new review.
Patients concerned about developing familial breast
cancer, which relates to a genetic problem, are increasingly requesting
referrals to genetic centers to have an assessment of their risk, for
reassurance and counseling, or for genetic testing. This demand has led
to the opening of a number of genetic clinics across the country
specifically dedicated to cancer.
The systematic review aimed to evaluate what impact
these genetic services are having on patients, and the reviewers werent
surprised to find positive results.
Many people have spent years worrying about cancer
in their family, said review co-author Rachel Iredale, Ph.D. A genetic
risk assessment enables people to reach a better understanding of
hereditary breast cancer, their own personal risk, and means access to
additional services, such as extra mammography screening or genetic
testing, is often easier. Most people are satisfied with the service
they receive.
The review appears in the current issue of The
Cochrane Library, a publication of The Cochrane Collaboration, an
international organization that evaluates research in all aspects of
health care. Systematic reviews draw evidence-based conclusions about
medical practice after considering both the content and quality of
existing trials on a topic.
According to the National Cancer Institute, more
than 192,000 women in the U.S. learn they have breast cancer each year
and about 5 percent to 10 percent of these women have a hereditary form.
A mutation or alteration of the BRCA1 or BRCA2
genes causes the known hereditary form. The NCI reports that women with
a mutation in either gene are three to seven times more likely to
develop breast cancer.
The Cochrane reviewers analyzed three studies
comprising 1,251 women who underwent genetic risk assessment for
hereditary breast cancer. Researchers assessed their understanding of
cancer risk and level of satisfaction with genetic counseling.
Iredale and her colleagues at the Institute of
Medical Genetics in Wales found that all studies showed that genetic
counseling improved patients psychological well-being and decreased
their levels of anxiety and worry about developing cancer.
Two studies showed patients were highly satisfied
with counseling. In one study, 82 percent said they liked counseling
very much, and in the other studies, more than half found it very
useful. All three studies showed that patients left with an improved
knowledge of breast cancer overall.
In short, the reviewers concluded that having a
risk assessment for familial cancer is beneficial for patients and
Iredale predicted that as the publics knowledge about genetic links to
cancer increases, so too will the need for more of these types of
services.
Demand for these genetic services is likely to
increase as genetic predispositions to other common conditions, such as
cardiovascular disease, become known, she said. Many of these
conditions are not gender-specific, though, so both women and men would
seek these new services.
Apostolos Psychogios, M.D., a medical geneticist at
Memorial Hospital in Savannah, Ga., agreed that demand for genetic
testing will increase, but said the medical field is not quite prepared
to handle the growth.
Today there are only about 1,170 medical
geneticists in the country who practice in a clinical setting, he said.
This means there is about one clinical geneticist to every 1.5 to 2
million people. We are very few and with more genetic discoveries and
advances in DNA testing on the horizon, we are not enough.
Psychogios added that at his institution, if a
genetic risk assessment shows a patient has the BRCA1 or BRCA2 mutation,
a team of health care professionals that includes a geneticist, an
oncologist and a genetic counselor are involved in helping the patient
make an informed decision on how to proceed.
Editor's Notes:
The Cochrane Collaboration is an international
nonprofit, independent organization that produces and disseminates
systematic reviews of health care interventions and promotes the search
for evidence in the form of clinical trials and other studies of
interventions. Visit
http://www.cochrane.org for
more information.
Source: Sivell S, et al. Cancer genetic risk
assessment for individuals at risk of familial breast cancer (Review).
Cochrane Database of Systematic Reviews 2007, Issue 2.
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