Randomized trial of specialist genetic assessment service for familial breast cancer

Brain, Kate, Gray, Jonathon, Norman, Paul, France, Elizabeth, Anglim, Cathy, Barton, Garry R., Parsons, Evelyn, Clarke, Angus, Sweetland, Helen, Tischkowitz, Marc, Myring, Jenny, Stansfield, Kate, Webster, David, Gower-Thomas, Kate, Daoud, Raouf, Gateley, Chris, Monypenny, Ian, Singhal, Hemant, Branston, Lucy, Sampson, Julian, Roberts, Elizabeth, Newcombe, Robert, Cohen, David, Rogers, Cerilan, Mansel, Robert and Harper, Peter (2000) Randomized trial of specialist genetic assessment service for familial breast cancer. Journal of the National Cancer Institute, 92 (16). pp. 1345-1351. ISSN 1460-2105

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Abstract

Background: Because of the growing demand for genetic assessment, there is an urgent need for information about what services are appropriate for women with a family history of breast cancer. Our purpose was to compare the psychologic impact and costs of a multidisciplinary genetic and surgical assessment service with those of current service provisions. Methods: We carried out a prospective randomized trial of surgical consultation with (the trial group) and without (the control group) genetic assessment in 1000 women with a family history of breast cancer. All P values are from two-sided tests. Results: Although statistically significantly greater improvement in knowledge about breast cancer was found in the trial group (P = .05), differences between groups in other psychologic outcomes were not statistically significant. Women in both groups experienced statistically significant reductions in anxiety and found attending the clinics to be highly satisfying. An initial specialist genetic assessment cost £14.27 (U.S. $22.55) more than a consultation with a breast surgeon. Counseling and genetic testing of affected relatives, plus subsequent testing of family members of affected relatives identified as mutation carriers, raised the total extra direct and indirect costs per woman in the trial group to £60.98 (U.S. $96.35) over costs for the control subjects. Conclusions: There may be little benefit in providing specialist genetics services to all women with a family history of breast cancer. Further investigation of factors that may mediate the impact of genetic assessment is in progress and may reveal subgroups of women who would benefit from specialist genetics services.

Item Type:	Article
Uncontrolled Keywords:	sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Groups > Health Economics
Depositing User:	EPrints Services
Date Deposited:	25 Nov 2010 11:12
Last Modified:	06 Jun 2023 14:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/14423
DOI:	10.1093/jnci/92.16.1345

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