BRCA1 TESTING IN A LARGE AFRICAN AMERICAN KINDRED

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This project proposes to address a critical gap in the literature regarding cancer susceptibility testing by examining utilization of genetic counseling and testing, and behavioral and psychosocial responses to the receipt of genetic information among a large, extended African American kindred (K2099) linked to a specific BRCA1 mutation. Information derived from this study may guide clinical interventions that help promote adherence to cancer prevention and screening guidelines for BRCAl mutation carriers and noncarriers and prevent psychosocial dysflmction related to receiving genetic information among families with characteristics similar to K2099. The findings from this study may also be translated into culturally appropriate interventions to promote healthy behaviors and coping. Female BRCA1 mutation carriers have a very high risk of developing breast or ovarian cancer. Male carriers are at an increased risk for prostate cancer and may transmit the BRCA1 mutation to their offspring. A prospective study of approximately 150 members of K2099 and their spouses/partners will be performed over a four year period. Genetic education and counseling will be provided when testing is offered and at the results session. Data will be collected through detailed questionnaires before and after testing on a wide range of behavioral and psychosocial measures. The specific aims are to: (1) identify predictors of the decision to choose or decline genetic counseling and testing services; (2) examine the attitudes towards BRCA1 testing among spouses/partners of adult female and male kindred members and determine how they influence BRCAl testing decisions; (3) evaluate the effects of genetic counseling and testing for BRCA1 mutations on psychological and social well being of kindred members and their spouses/partners; (4) identify how genetic counseling and testing, and knowledge of BRCA1 mutation carrier status influences utilization of health services and health behaviors among adult women and men; and (5) describe facilitators and barriers to genetic counseling and testing and utilization of screening and preventive measures for BRCA1 mutation-linked cancers.