Abstract
ObjectiveTo develop a generic scale for assessing attitudes towards genetic testing and to psychometrically assess these attitudes in the context of BRCA1/2 among a sample of French general practitioners, breast specialists and gyneco-obstetricians.Study design and settingNested within the questionnaire developed for the European InCRisC (International Cancer Risk Communication Study) project were 14 items assessing expected benefits (8 items) and drawbacks (6 items) of the process of breast/ovarian genetic cancer testing (BRCA1/2). Another item assessed agreement with the statement that, overall, the expected health benefits of BRCA1/2 testing exceeded its drawbacks, thereby justifying its prescription. The questionnaire was mailed to a sample of 1,852 French doctors. Of these, 182 breast specialists, 275 general practitioners and 294 gyneco-obstetricians completed and returned the questionnaire to the research team. Principal Component Analysis, Cronbach’s α coefficient, and Pearson’s correlation coefficients were used in the statistical analyses of collected data.ResultsThree dimensions emerged from the respondents’ responses, and were classified under the headings: “Anxiety, Conflict and Discrimination”, “Risk Information”, and “Prevention and Surveillance”. Cronbach’s α coefficient for the 3 dimensions was 0.79, 0.76 and 0.62, respectively, and each dimension exhibited strong correlation with the overall indicator of agreement (criterion validity).ConclusionsThe validation process of the 15 items regarding BRCA1/2 testing revealed satisfactory psychometric properties for the creation of a new scale entitled the Attitudes Towards Genetic Testing for BRCA1/2 (ATGT-BRCA1/2) Scale. Further testing is required to confirm the validity of this tool which could be used generically in other genetic contexts.
Highlights
The first genes causing susceptibility to breast/ovarian cancer (BRCA1/2 genes) were identified approximately twenty-five years ago [1]
One of the positive outcomes of BRCA1/2 genetic cancer testing is that when a pathogenic germline variant has been identified, surveillance and preventive strategies can reduce breast/ovarian cancer incidence and increase life expectancy [7, 8]
While there is sufficient evidence to show the benefit of risk-reducing surgery for breast/ovarian cancer, evidence is lacking for intensive screening [9]
Summary
The first genes causing susceptibility to breast/ovarian cancer (BRCA1/2 genes) were identified approximately twenty-five years ago [1]. Results from different studies have highlighted the favorable impact of genetic testing, since the majority of those identified with BRCA1/2 mutations in those studies adopted preventive strategies, including risk-reducing surgery and/or surveillance using imaging technologies. Another major outcome of a positive mutation test is that the risk of breast cancer running in a family can be assessed, that uncertainty regarding genetic risk can be removed, and strategies can be implemented to protect children and future generations [13]
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