Abstract
To determine whether receiving melanoma genetic test results undermines perceived control over melanoma prevention, control-related beliefs were examined among 60 adults from melanoma-prone families receiving CDKN2A/p16 test results (27 unaffected noncarriers, 15 unaffected carriers, 18 affected carriers; response rate at 2 years = 64.9 % of eligible respondents). Multilevel modeling of perceived control ratings over a 2-year period revealed significant variation in individual trajectories: most participants showed increases (45 %) or no change (38.3 %), while 16.7 % showed decreases. At the group level, noncarriers reported sustained increases through the 2-year follow-up (ps < .05); unaffected carriers reported significant short-term increases (ps < .05); and affected carriers reported no change. Participants in all groups continued to rate photoprotection as highly effective in reducing melanoma risk and reported decreased beliefs that carrying the p16 mutation would inevitably lead to the development of melanoma. Qualitative responses immediately following counseling and test reporting corroborated these findings, as 93 % indicated it was possible to either prevent (64.9 %) or decrease the likelihood (28.1 %) of future melanomas. Thus, genetic test reporting does not generally undermine perceived control over melanoma prevention, though variability in response to positive results warrants future study.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 754-765 |
| Number of pages | 12 |
| Journal | Journal of Behavioral Medicine |
| Volume | 38 |
| Issue number | 5 |
| DOIs | |
| State | Published - Oct 21 2015 |
Funding
This work was supported by a Funding Incentive Seed Grant, Office of the Vice President for Research, University of Utah, and a Huntsman Cancer Institute (HCI) CCPS Pilot Project Award to Drs. Aspinwall and Leachman. Additional support was received from the Huntsman Cancer Foundation (HCF), the Tom C. Mathews, Jr. Familial Melanoma Research Clinic endowment, HCI’s Pedigree and Population Resource, the Utah Population Database, and the Utah Cancer Registry, which is funded by contract N01-PC-35141 from the National Cancer Institute (NCI) SEER Program with additional support from the Utah State Department of Health and the University of Utah. The authors used core facilities supported by the National Institutes of Health (NIH) through NCI Cancer Center Support Grant 5P30CA420-14 awarded to HCI, the genetic counseling core facility supported by HCF, and National Center for Research Resources Grant 1KL2RR025763-01 awarded to the University of Utah by the NIH Office of the Director. The authors acknowledge NCI R01 CA158322-01 for partial support during article preparation. Content is the authors’ responsibility and does not necessarily represent views of NCI or NIH. The authors gratefully acknowledge study participants; and Marybeth Hart, Erin Dola, Lisa Wadge, Amber Kostial, Emily Bullough, Michelle Welch, Candace Larson, and Taylor Haskell for contributions to the conduct or management of the study.
Keywords
- CDKN2A/p16
- Familial melanoma
- Genetic counseling
- Genetic determinism
- Perceived control
- Prevention
ASJC Scopus subject areas
- Psychiatry and Mental health
- General Psychology
