Psychological and social predictors of decisions about genetic testing for breast cancer in high-risk women

The social, psychological and demographic factors associated with the decision of high-risk women to undergo breast cancer gene testing were investigated within the framework of the Health Belief Model (HBM). Participants were 108 Canadian volunteers from the following groups: (1) women who had at least one female blood relative diagnosed with breast cancer within the past two years (HR group; n = 58) and (2) women from the general population who had never been diagnosed with cancer of any type (GP group; n = 50). All participants completed a survey designed to collect demographic information, familial cancer history, disease perceptions/attitudes and interest in gene testing for breast cancer susceptibility. As expected, the attitudes of HR group women about gene testing differed from those in the general population on a number of variables. Specifically, women with an affected family member were more likely to be interested in genetic testing than those from the general population. Perceptions of increased personal risk for ovarian cancer were associated with interest in genetic testing for BRCA1/BRCA2 mutations among women with a family history of the disease. With respect to HBM variables, greater perceived psychological benefits and fewer perceived costs of BRCA1/BRCA2 testing were associated with interest in gene testing for women in both groups. Understanding the sociodemographic and individual predictors of interest in genetic testing will provide more realistic estimates regarding demand for breast cancer gene testing and will assist in the development of effective genetic counselling protocols for high-risk women.