Cancer surveillance and distress among adult pathogenic TP53 germline variant carriers in Germany: A multicenter feasibility and acceptance survey.


Journal

Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236

Informations de publication

Date de publication:
01 09 2020
Historique:
received: 05 02 2020
revised: 06 04 2020
accepted: 04 05 2020
pubmed: 20 6 2020
medline: 22 5 2021
entrez: 20 6 2020
Statut: ppublish

Résumé

Li-Fraumeni syndrome (LFS) is a high-risk cancer predisposition syndrome caused by pathogenic germline variants of TP53. Cancer surveillance has noted a significant survival advantage in individuals with LFS; however, little is known about the feasibility, acceptance, and psychosocial effects of such a program. Pathogenic TP53 germline variant carriers completed a 7-part questionnaire evaluating sociodemographics, cancer history, surveillance participation, reasons for nonadherence, worries, and distress adapted from the Cancer Worry Scale. Counselees' common concerns and suggestions were assessed in MAXQDA Analytics Pro 12. Forty-nine participants (46 females and 3 males), aged 40.0 ± 12.6 years, formed the study population; 43 (88%) had a personal cancer history (including multiple cancers in 10 [20%]). Forty-three individuals participated (88%) in surveillance during the study or formerly. Willingness to undergo surveillance was influenced by satisfaction with genetic testing and counseling (P = .019 [Fisher-Yates test]) but not by sociodemographics, cancer history, or distress level. Almost one-third of the participants reported logistical difficulties in implementing surveillance because of the high frequency of medical visits, scheduling difficulties, and the travel distance to their surveillance providers. Self-reported distress and perceived emotional burden for family members and partners were moderate (median for self-reported distress, 3.3; median for perceived emotional burden, 3.0). For both, the interquartile range was moderate to very high (2.7-3.7 and 3.0-3.7, respectively). Individuals with LFS require efficient counseling as well as an accessible, well-organized, interdisciplinary, standardized surveillance program to increase adherence and psychological coping.

Sections du résumé

BACKGROUND
Li-Fraumeni syndrome (LFS) is a high-risk cancer predisposition syndrome caused by pathogenic germline variants of TP53. Cancer surveillance has noted a significant survival advantage in individuals with LFS; however, little is known about the feasibility, acceptance, and psychosocial effects of such a program.
METHODS
Pathogenic TP53 germline variant carriers completed a 7-part questionnaire evaluating sociodemographics, cancer history, surveillance participation, reasons for nonadherence, worries, and distress adapted from the Cancer Worry Scale. Counselees' common concerns and suggestions were assessed in MAXQDA Analytics Pro 12.
RESULTS
Forty-nine participants (46 females and 3 males), aged 40.0 ± 12.6 years, formed the study population; 43 (88%) had a personal cancer history (including multiple cancers in 10 [20%]). Forty-three individuals participated (88%) in surveillance during the study or formerly. Willingness to undergo surveillance was influenced by satisfaction with genetic testing and counseling (P = .019 [Fisher-Yates test]) but not by sociodemographics, cancer history, or distress level. Almost one-third of the participants reported logistical difficulties in implementing surveillance because of the high frequency of medical visits, scheduling difficulties, and the travel distance to their surveillance providers. Self-reported distress and perceived emotional burden for family members and partners were moderate (median for self-reported distress, 3.3; median for perceived emotional burden, 3.0). For both, the interquartile range was moderate to very high (2.7-3.7 and 3.0-3.7, respectively).
CONCLUSIONS
Individuals with LFS require efficient counseling as well as an accessible, well-organized, interdisciplinary, standardized surveillance program to increase adherence and psychological coping.

Identifiants

pubmed: 32557628
doi: 10.1002/cncr.33004
doi:

Substances chimiques

TP53 protein, human 0
Tumor Suppressor Protein p53 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

4032-4041

Informations de copyright

© 2020 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.

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Auteurs

Nathalie Rippinger (N)

Department of Gynecology and Obstetrics, University Hospital Heidelberg, Heidelberg, Germany.

Christine Fischer (C)

Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany.

Markus W Haun (MW)

Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.

Kerstin Rhiem (K)

Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology, Medical Faculty, University Hospital Cologne, Cologne, Germany.

Sabine Grill (S)

Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Comprehensive Cancer Center, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.

Marion Kiechle (M)

Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Comprehensive Cancer Center, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.

Friedrich W Cremer (FW)

SYNLAB Center for Human Genetics, Mannheim, Germany.

Karin Kast (K)

Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
National Center for Tumor Diseases, Partner Site Dresden, Dresden, Germany.
German Cancer Consortium and German Cancer Research Center, Dresden, Germany.

Huu P Nguyen (HP)

Institute of Medical Genetics and Applied Genomics, University Hospital of Tübingen, Tübingen, Germany.
Department of Human Genetics, University of Bochum, Bochum, Germany.

Nina Ditsch (N)

Department of Gynecology and Obstetrics, Ludwig Maximilian University, University Hospital of Munich, Munich, Germany.
Department of Gynecology and Obstetrics, University Hospital Augsburg, Augsburg, Germany.

Christian P Kratz (CP)

Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany.

Julia Vogel (J)

Department of Gynecology and Obstetrics, University Hospital Charité Berlin, Berlin, Germany.

Dorothee Speiser (D)

Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Simone Hettmer (S)

Translational Functional Cancer Genomics, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany.

Hanno Glimm (H)

German Cancer Consortium and German Cancer Research Center, Dresden, Germany.
Translational Functional Cancer Genomics, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany.
Department of Translational Medical Oncology, National Center for Tumor Diseases, University Hospital Carl Gustav Carus, Technical University Dresden and German Cancer Research Center, Heidelberg, Germany.

Stefan Fröhling (S)

Department of Translational Medical Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany.
German Cancer Consortium and German Cancer Research Center, Heidelberg, Germany.

Dirk Jäger (D)

German Cancer Consortium and German Cancer Research Center, Heidelberg, Germany.
Department of Medical Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany.

Stephan Seitz (S)

Department of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany.

Andrea Hahne (A)

BRCA Network-Support for People with Hereditary Cancers.

Imad Maatouk (I)

Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.

Christian Sutter (C)

Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany.

Rita K Schmutzler (RK)

Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology, Medical Faculty, University Hospital Cologne, Cologne, Germany.

Nicola Dikow (N)

Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany.

Sarah Schott (S)

Department of Gynecology and Obstetrics, University Hospital Heidelberg, Heidelberg, Germany.

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