Perceived risk and emotional distress after the first visit at a genetic counseling unit

Abstract

Objective: To analyze how perceived risk and emotional distress were affected by the first visit to a Genetic Counseling Unit in patients with a family history of hereditarian breast cancer, ovarian cancer, or colorectal cancer. Methods: Risk perception of suffering cancer at 1 year, at 10 years, and across the life span, as well as emotional distress (assessed as sadness, anxiety and worries during the last week) was assessed in three moments: before the first visit to the Genetic Counseling Unit, immediately after finishing the visit, and 2-3 weeks after the first visit. Results: Emotional distress prior the first visit was observed in 30% of patients, with higher levels in patients without job. The first visit decreased emotional distress in most cases. However, 34% of patients stated that they were more anxious after the visit, 32% of patients become sadder, and 23% of patients were more worried. Patients who expressed increased levels of emotional distress after the visit were worried about their sons (or sons they wanted to have in the future). In spite of that, this emotional distress decreased at 2-3 weeks. The first visit to a Genetic Counseling Unit decreased risk perception of having cancer across the life span (p<.01), and there were not differences between the three types of cancer. Conclusions: First visit to a Genetic Counseling Unit decreases overestimation of risk perception of having cancer. Approximately one third of patients increased their emotional distress after the visit. Most studies are needed in order to clarify whether this increase in emotional distress is unavoidable for some patients at the beginning of the genetic counseling process, or it can be reduced if some features of the protocol applied during the visit are changed.