An interactive computer program can help educate women about breast cancer risk and genetic testing

An interactive computer program can help educate women about breast cancer risk and genetic testing, and a decision board offering information on treatment options can help breast cancer patients choose between mastectomy and breast-conserving therapy, according to articles in the July 28 issue of JAMA, the Journal of the American Medical Association.

In the first of two studies, Michael J. Green, M.D., M.S., of Penn State College of Medicine, Hershey, Pa., and colleagues compared the effectiveness of an interactive, multimedia CD ROM-based decision aid with standard genetic counseling for educating women about BRCA1 and BRCA2 genetic testing. BRCA1 and BRCA2 are genes that help control normal cell growth. People who inherit specific mutations in one or both of these genes have an increased risk of developing breast cancer. People who carry these mutations and have family members with breast cancer are more likely to develop the disease.

According to background information in the article, genetic testing for inherited cancer predisposition has become widely available. But as the availability of and demand for genetic testing for hereditary cancers increases in primary care and other clinical settings, alternative or adjunct educational methods to traditional genetic counseling will be needed.

The authors conducted a randomized controlled trial at outpatient clinics at six U.S. medical centers from May 2000 to September 2002. Among 211 women with personal or family histories of breast cancer, 105 received standard one-on-one genetic counseling, and 106 received education by a computer program, followed by genetic counseling. Both groups had comparable demographics, prior computer experience, medical literacy, and baseline knowledge of breast cancer and genetic testing. The authors looked at outcome measures that tested factual knowledge, assessed decision making, and measured emotional reactions - such as anxiety, conflict, and satisfaction.

"An interactive computer program was more effective than standard genetic counseling for increasing knowledge of breast cancer and genetic testing among women at low risk of carrying a BRCA1 or BRCA2 mutation," the authors report.

"However, genetic counseling was more effective than the computer at reducing women's anxiety and facilitating more accurate risk perceptions."

The authors believe their findings support the use of an interactive computer program to educate women about breast cancer risk and genetic testing.


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