Highlights
- •Familial breast cancer risk was self-assessed in population-based breast cancer screening.
- •About 4% of women have high risk and are potential candidates for BRCA1/2 genetic testing.
- •Self-assessment of familial breast cancer risk did not induce anxiety or distress.
- •Therefore the online self-test may be added to population-based breast cancer screening.
- •An online referral test version is available at www.erfelijkekanker.nl/test.
Abstract
Introduction
Identifying high familial breast cancer (FBC) risk improves detection of yet unknown
BRCA1/2-mutation carriers, for whom BC risk is both highly likely and potentially
preventable. We assessed whether a new online self-test could identify women at high
FBC risk in population-based BC screening without inducing anxiety or distress.
Methods
After their visit for screening mammography, women were invited by email to take an
online self-test for identifying highly increased FBC risk-based on Dutch guidelines.
Exclusion criteria were previously diagnosed as increased FBC risk or a personal history
of BC. Anxiety (State-Trait Anxiety Inventory Dutch Version), distress (Hospital Anxiety
Depression Scale) and BC risk perception were assessed using questionnaires, which
were completed immediately before and after taking the online self-test and 2 weeks
later.
Results
Of the 562 women invited by email, 406 (72%) completed the online self-test while
304 also completed questionnaires (response rate 54%). After exclusion criteria, 287
(51%) were included for data analysis. Median age was 56 years (range 50–74). A high
or moderate FBC risk was identified in 12 (4%) and three (1%) women, respectively.
After completion of the online self-test, anxiety and BC risk perception were decreased
while distress scores remained unchanged. Levels were below clinical relevance. Most
women (85%) would recommend the self-test; few (3%) would not.
Conclusion
The online self-test identified previously unknown women at high FBC risk (4%), who
may carry a BRCA1/2-mutation, without inducing anxiety or distress. We therefore recommend
offering this self-test to women who attend population-based screening mammography
for the first time.
Keywords
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Article info
Publication history
Published online: April 14, 2017
Accepted:
March 13,
2017
Received in revised form:
March 2,
2017
Received:
January 22,
2017
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
