When should children or teens be told about familial cancer risk? There might be important harm related to the psychological impact of the information but knowing the information could be important for the health of the individual and could inform future personal decisions.
To evaluate these issues, McDonnell et al (10.1542/peds.2022-056339) share with us an interesting analysis from a cross-sectional, mixed methods study involving 272 adolescents and young adults (AYAs) of mothers who were survivors of breast and ovarian cancer who had BRCA testing. These mothers disclosed their BRCA status to their AYA children (at ages 12 to 24 years) who had not had BRCA testing yet. The AYAs in the study were asked about their own cancer risk behaviors, including the use of alcohol and tobacco, and their level of psychologic distress.
The AYAs in this study believed themselves to be at greater risk for cancer than AYAs of mothers without cancer, but it was their mother’s cancer history alone that increased their perceptions of cancer risk. Maternal BRCA+ status had no significant influence on AYA lifestyle behavior or adversely impacted their quality of life. However, AYAs of BRCA+ mothers were more interested in genetic testing to determine their personal risk.
What is our role as clinicians in working with these AYAs in the setting of a family cancer diagnosis? To answer that question, we invited Dr. Colin Moore from the Moffit Cancer Center in Tampa, Florida, along with Darcy Berry and Kathleen Gewandter (both genetic counselors working with Dr. Moore) to share with us their take-aways from this study in an accompanying commentary (10.1542/peds.2022-057087). The commentary authors point out the strengths and limitations of this study and highlight how this study helps us by demonstrating that the disclosure of BRCA results does not seem to increase psychological distress in AYAs. These same authors remind us of the role we need to play to help AYAs with a family risk for cancer connect with genetic counselors and suggest resources we can share with families in their desire to discuss genetic test results with their AYAs. There is a lot of helpful information contained in both the study and commentary so link to both to learn more.