"I remember how I felt, but I don't remember the gene": Families' experiences of cancer-related genetic testing in childhood.


Journal

Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624

Informations de publication

Date de publication:
08 2019
Historique:
received: 03 02 2019
revised: 02 04 2019
accepted: 04 04 2019
pubmed: 23 4 2019
medline: 15 1 2020
entrez: 23 4 2019
Statut: ppublish

Résumé

Genetic testing in children for hereditary cancer predisposition syndromes (CPSs) involves unique psychosocial and family-systems considerations. This retrospective study explored the perspectives and emotional reactions of parents and young adults about cancer-related genetic counseling and testing offered to children in the family. Families were eligible if they had considered genetic testing for a child (≤18 years) within the family. Parents and young adults ≥16 years participated in semistructured interviews that we coded and identified key themes. We also quantitively assessed emotional distress, quality of life, impact of receiving genetic cancer risk information, and service-related satisfaction. From 35 interviews (26 parents, nine young adults), we identified themes spanning families' experiences from referral to genetic services to the longer term impact of receiving information about family cancer risk from testing of children. Supported by quantitative data, families generally described positive experiences of genetic services and reported benefits to genetic testing. Nevertheless, families faced unique emotional and relational challenges that changed over the family lifecycle. Those challenges differed according to whether the child was asymptomatic or had a cancer diagnosis at testing. Parents of children with cancer described genetic consultations as a secondary concern to the immediate stressors of their child's treatment. We conclude that the successful integration of cancer genetics into pediatric cancer care requires specialist pediatric genetic counseling and psychosocial support services that are able to respond to families' changing needs.

Sections du résumé

BACKGROUND
Genetic testing in children for hereditary cancer predisposition syndromes (CPSs) involves unique psychosocial and family-systems considerations. This retrospective study explored the perspectives and emotional reactions of parents and young adults about cancer-related genetic counseling and testing offered to children in the family.
METHODS
Families were eligible if they had considered genetic testing for a child (≤18 years) within the family. Parents and young adults ≥16 years participated in semistructured interviews that we coded and identified key themes. We also quantitively assessed emotional distress, quality of life, impact of receiving genetic cancer risk information, and service-related satisfaction.
RESULTS
From 35 interviews (26 parents, nine young adults), we identified themes spanning families' experiences from referral to genetic services to the longer term impact of receiving information about family cancer risk from testing of children. Supported by quantitative data, families generally described positive experiences of genetic services and reported benefits to genetic testing. Nevertheless, families faced unique emotional and relational challenges that changed over the family lifecycle. Those challenges differed according to whether the child was asymptomatic or had a cancer diagnosis at testing. Parents of children with cancer described genetic consultations as a secondary concern to the immediate stressors of their child's treatment.
CONCLUSIONS
We conclude that the successful integration of cancer genetics into pediatric cancer care requires specialist pediatric genetic counseling and psychosocial support services that are able to respond to families' changing needs.

Identifiants

pubmed: 31006986
doi: 10.1002/pbc.27762
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e27762

Informations de copyright

© 2019 Wiley Periodicals, Inc.

Auteurs

Brittany C McGill (BC)

School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia.
Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Sydney, New South Wales, Australia.

Claire E Wakefield (CE)

School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia.
Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Sydney, New South Wales, Australia.

Janine Vetsch (J)

School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia.
Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Sydney, New South Wales, Australia.

Qishan Lim (Q)

School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia.
Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Sydney, New South Wales, Australia.

Meera Warby (M)

Hereditary Cancer Clinic, Department of Medical Oncology, Prince of Wales Hospital, Randwick, New South Wales, Australia.

Alison Metcalfe (A)

Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, United Kingdom.

Jennifer A Byrne (JA)

Molecular Oncology Laboratory, Children's Cancer Research Unit, Kids Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
The University of Sydney Discipline of Child and Adolescent Health, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.

Richard J Cohn (RJ)

School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia.
Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Sydney, New South Wales, Australia.

Katherine M Tucker (KM)

Hereditary Cancer Clinic, Department of Medical Oncology, Prince of Wales Hospital, Randwick, New South Wales, Australia.
Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.

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