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Author Notes:

Steven J. Katz, MD, MPH, Departments of Medicine and, Health Management and Policy, University of Michigan Medicine, North Campus Research Complex, 2800 Plymouth Rd, B16 Rm 410E, Ann Arbor, MI 48109-2800; e-mail: skatz@med.umich.edu

We thank Jill S. Dolinsky, CGC, and Melissa Pronold at Ambry Genetics, Delores Bowman and Benjamin Solomon at GeneDx, Edward Esplin and Stephen Lincoln at Invitae, and Johnathan Lancaster and Brian Dechairo at Myriad Genetics for their collaboration on the genetic test data linkage to SEER data. Written permission was obtained to include the names of all acknowledged individuals.

Conception and design: Steven J. Katz, Kevin C. Ward, Allison W. Kurian. Financial support: Steven J. Katz. Administrative support: Steven J. Katz. Provision of study materials or patients: Ann S. Hamilton. Collection and assembly of data: Steven J. Katz, Kevin C. Ward, Ann S. Hamilton, Paul Abrahamse, Sarah T. Hawley. Data analysis and interpretation: Steven J. Katz, Kevin C. Ward, Paul Abrahamse, Allison W. Kurian. Manuscript writing: All authors. Final approval of manuscript: All authors. Accountable for all aspects of the work: All authors.

Allison W. Kurian Research Funding: Myriad Genetics

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Research Funding:

Supported by Grant No. P01 CA163233 to the University of Michigan from the National Cancer Institute. Conducted work was also supported by the University of Michigan Cancer Center Biostatistics, Analytics and Bioinformatics shared resource (P30CA46592). The collection of Los Angeles County cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885, Centers for Disease Control and Prevention’s (CDC’s) National Program of Cancer Registries, under cooperative agreement 5NU58DP003862-04/DP003862, the National Cancer Institute’s SEER Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California, and contract HHSN261201000034C awarded to the Public Health Institute. The collection of cancer incidence data in Georgia was supported by contract HHSN261201300015I, Task Order HHSN26100006 from the National Cancer Institute and cooperative agreement 5NU58DP003875-04-00 from the CDC.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • RISK

Association of Germline Genetic Test Type and Results With Patient Cancer Worry After Diagnosis of Breast Cancer

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Journal Title:

JCO PRECISION ONCOLOGY

Volume:

Volume 2

Publisher:

, Pages 1-8

Type of Work:

Article | Final Publisher PDF

Abstract:

Background There are concerns that multigene panel testing compared with BRCA1/2-only testing after diagnosis of breast cancer may lead to unnecessary patient worry about cancer because of more ambiguous results. Methods Patients with breast cancer diagnosed from 2013 to 2015 and accrued from SEER registries in Georgia and Los Angeles were surveyed (n = 5,080; response rate, 70%), and responses were merged with SEER data and germline genetic testing and results. We examined patient reports of cancer worry by test type and results in 1,063 women who linked to a genetic test and reported undergoing testing. Results More than half of the sample (n = 640; 60.2%) received BRCA1/2-only testing versus 423 patients (39.8%) who had a multigene panel. A minority of tested patients reported substantial cancer worry after treatment: 11.1% (n = 130) reported higher impact of cancer worry, and 15.1% (n = 162) reported a high frequency of cancer worry (worrying often or almost always) in the past month. Impact of cancer worry did not substantively differ by test type, test result outcomes, or clinical or treatment factors. The odds ratio for higher impact of cancer worry was 0.81 (95% CI, 0.51 to 1.28) for multigene versus BRCA1/2-only testing. In a separate model, the odds ratios were 1.21 (95% CI, 0.54 to 2.68) and 0.90 (95% CI, 0.50 to 1.62) for pathogenic variant and variant of uncertain significance, respectively, versus a negative test (the reference group). Conclusion Compared with BRCA1/2 testing alone, multigene panel testing was not associated with increased cancer worry after diagnosis of breast cancer.

Copyright information:

© 2018 by American Society of Clinical Oncology

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