Genetic Testing and Breast Cancer -- An effective strategy for creating motivation for health behaviour change?

     Genetic testing is currently being used for untreatable conditions, such as breast cancer. Genetic testing for breast cancer is an effective strategy to create risk perceptions that motivate health behaviour change. If you have been genetically tested for breast cancer, and the results turn up positive, you will have a much higher than average chance of developing the cancer over the span of your lifetime. This is 3-7 times greater chance for developing breast cancer, than women who do not have the genetic mutation (40-85%).

     The benefits for genetic testing outweigh the cons. By getting testing, you can determine if you are at a higher risk of developing the disease and can take effective measures to lower your chance. By knowing your susceptibility to the disease, you can take medications to reduce the risk of developing breast cancer or change your lifestyle to slow down the rate of development. You may do frequent clinical exams and breast scans—every 6 months rather than once a year—or you may want to take surgical measures, such as removal of breasts before cancer has the time to form. The genetic testing will allow you to become more aware of the situation, and take appropriate measures to reduce your risk.

     It is estimated that approximately 207,090 new cases of invasive breast cancer are expected to be diagnosed in American Women, and 54,010 new cases of non-invasive breast cancer (Breast Cancer.org, 2010). Approximately 39,840 women are expected to die in 2010 from breast cancer; these death rates are higher than any other cancer, besides lung cancer (Breast Cancer.org, 2010). It is important to take prevention measures, such as genetic testing, to lower their mortality rates.

     Genetic testing could increase or decrease the motivation to change their behaviour. Marteau and Lerman (2001), state that genetic testing might increase motivation by emphasizing the fact that the current behaviour, combined with the genetic predisposition, will put the individual at greater risk of disease. It could also increase motivation by reinforcing the benefits of treatments based on that specific genotype information. Compared to the individual’s negative perceptions on genetic testing might decrease their motivation to change behaviour. They may believe genetic risks are immutable; thus, decreasing their attitudes that changing the behaviour will reduce risks. The behaviour changes are most likely to occur in individuals who are willing to participate in interventions and in those that can be persuaded easily. Women may change their behaviour if they are aware of reduce risks of an adverse health outcome, such as breast cancer.

     People may avoid getting genetic testing for breast cancer because they may not be able to deal with the results. Contrary to this, a systemic review was done by Butow et al. (2003) indicating, “Genetic testing appears to produce psychological benefits. Carriers do not seem to experience a significant increase in depression or anxiety after disclosure of their mutation status, while non-carriers experience significant relief.”

Genetic testing is beneficial; however, effective counselling and programs are needed to motivate their new lifestyle changes, once the genetic information is provided.   

Evidence:

Psychological outcomes and risk perception after genetic testing and counselling in breast cancer: a systematic review systematic+review+psyc+outcomes.pdf

By: Phyllis N Butow, Elizabeth A Lobb, Bettina Meiser, Alexandra Barratt and Katherine M Tucker

Genetic Risk and Behaviour Change by Marteau, Lerman, Volume 22, 2001 http://www.bmj.com/content/322/7293/1056.full.pdf+html

Breast Cancer http://www.breastcancer.org/