Perception of Gene-Environment Cancer Risks in Melanoma

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DESCRIPTION (provided by applicant): The overall goal of this career development application is to launch an independent research program on perception of gene-environment cancer risks. There is mounting evidence that common genetic polymorphisms can either accentuate or attenuate environmental risks, such as smoking and sun exposure, and that these interactions are a primary etiological pathway to carcinogenesis. In the coming years, it is likely that a growing number of individuals will receive probabilistic information concerning genetic and environmental cancer risk factors. The number of individuals who are affected will exceed those with uncommon, highly penetrant single-gene mutations. Existing research on cancer risk communication targeted to those with single risk factors, such as genetic mutations alone, or lifestyle risk factors alone, do not adequately address the potential challenges and prevention opportunities presented by our increasingly comprehensive understanding of environmental and genetic risk interactions. Gene-environment interactions are implicated in the etiology of a number cancer sites. Melanoma will provide the paradigm for study in this application because of the evidence for gene-environment etiology, rising incidence rates, and promise of behavioral prevention. Given the current absence of identified germ line mutations, studying first-degree relatives of melanoma patients will provide a vehicle in the proposed studies to examine the role of gene-environment risk perceptions and both skin cancer screening and sun protection behavior. Study I is a qualitative interview study of risk perceptions among first-degree relatives of melanoma patients. Study II is a prospective assessment of risk perceptions, skin cancer screening, and sun protection behaviors among first degree-relatives of recently diagnosed melanoma patients. Through intensive interaction with multidisciplinary colleagues, formal epidemiology coursework, teaching, and research, this career development award will establish my multidisciplinary research skills at the interface of genetic epidemiology and behavioral science, and position me to establish novel theory and measurement strategies for the role of risk perceptions of gene-environment interactions, and ultimately to develop communication models of gene-environment cancer risks which will be applicable to other cancer sites.