Abstract

BackgroundGenetic counseling for hereditary breast or colon cancer has implications for both counselees and their relatives. Although counselees are encouraged by genetic counselors to disclose genetic cancer risk information, they do not always share this information with their at-risk relatives. Reasons for not informing relatives may be generally categorized as a lack of knowledge, motivation and/or self-efficacy. Presented here is the protocol of a randomized controlled trial that aims to establish the effectiveness of an intervention focused on supporting counselees in their disclosure of genetic cancer information to their relatives.Methods/DesignA multicenter randomized controlled trial with parallel group design will be used to compare the effects of an additional telephone counseling session performed by psychosocial workers to enhance the disclosure of genetic cancer information to at-risk relatives (intervention group) with a control group of standard care. Consecutive index patients with relatives at risk for hereditary or familial breast and/or ovarian cancer or colon cancer, are randomly assigned (block size: 8; 1:1 allocation ratio) to the intervention (n = 132) or control group (n = 132, standard care). Primary outcomes are counselees’ knowledge, motivation and self-efficacy regarding informing their relatives.DiscussionThis intervention may prove important in supporting counselees to disclose hereditary and/or familial cancer risk information to at-risk relatives and may enable more at-risk relatives to make a well-informed decision regarding genetic services and/or screening.Trial registrationThis trial is registered in the Netherlands National Trial Register (NTR) with trial ID number NTR3745.

Highlights

  • Genetic counseling for hereditary breast or colon cancer has implications for both counselees and their relatives

  • This intervention may prove important in supporting counselees to disclose hereditary and/or familial cancer risk information to at-risk relatives and may enable more at-risk relatives to make a well-informed decision regarding genetic services and/or screening

  • This paper describes the design of a randomized controlled trial (RCT) for investigating the effectiveness of an intervention based on the principles of Motivational Interviewing (MI) [31]

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Summary

Introduction

Genetic counseling for hereditary breast or colon cancer has implications for both counselees and their relatives. Counselees are encouraged by genetic counselors to disclose genetic cancer risk information, they do not always share this information with their at-risk relatives. Reasons for not informing relatives may be generally categorized as a lack of knowledge, motivation and/or self-efficacy. Identification of hereditary or familial breast or colorectal cancer risks has implications for counselees and for their relatives. Counselees report that they generally feel responsible to disclose genetic risk information to relatives [8,9,10], they do not always succeed in correctly informing all relevant relatives [11,12,13,14,15]. A lack of self-efficacy may lead to counselees feeling unable to inform their relatives. The counselee does not deliberately withhold information but may feel insecure about correctly disclosing the complex or burdensome information [22]

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