The role of social support and stress coping strategies in genetic screening for cancer predisposition – BRCA testing as an example
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Division of Quality of Life Research, Department of Psychology, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdańsk, Poland
Rare Diseases Centre, Medical University of Gdansk, Gdansk, Poland
Clinical Genetics Unit, Department of Biology and Medical Genetics, Medical University of Gdansk, Gdansk, Poland
Katarzyna Milska-Musa   

Division of Quality of Life Research, Department of Psychology, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdańsk, Poland. Tel.: +48 602 454 220.
Submission date: 2022-06-10
Final revision date: 2022-06-23
Acceptance date: 2022-06-23
Online publication date: 2023-05-04
Pol. Ann. Med. 2023;30(1):15–24
Individuals with monoallelic pathogenic variants in BRCA1/BRCA2 genes are at an increased risk of developing breast or ovarian cancer. The results of genetic tests may present a stressor related to the fear associated with the impact of the diagnosis on an individual’s future.

The aim of the study was to verify the level of depression, anxiety, and stress in individuals waiting for the results of BRCA genetic tests. How personality traits, stress coping strategies and social support influence the level of mental discomfort was examined.

Material and methods:
82 consecutive individuals completed an anonymous online survey consisting of basic information and five questionnaires: the Inventory for Measuring Coping with Stress (Mini-COPE), the Depression, Anxiety and Stress Scale (DASS-21), the Generalized Anxiety Disorder 7-Item Scale (GAD-7), Polish adaptation of the Ten Item Personality Inventory test (TIPI-PL), and the Berlin Social Support Scales (BSSS).

Results and discussion:
Participants obtained the highest scores in Mini-COPE strategies: active coping, planning, positive reframing, acceptance, and seeking emotional support. The results of DASS-21 and GAD-7 indicate the level of depression, anxiety, and stress mainly in the normal range. The highest scores in the TIPI-PL test were obtained on the conscientiousness, agreeableness, and extraversion scales. Participants, who have already obtained the results had higher scores on the Need for Support Scale (BSSS).

In general, the situation of BRCA genetic testing is not causing significant negative mental discomfort. Nonetheless, the results indicate a significant role of social support in coping with stress in individuals who have already obtained the results of their genetic test.

The authors don’t declare any source of fundings.
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Ahmad A. Breast cancer statistics: Recent trends. In: Ahmad A, eds. Breast Cancer Metastasis and Drug Resistance. Advances in Experimental Medicine and Biology. Cham: Springer. 2019;1152.
Cardoso F, Loibl S, Pagani O, et al. The European Society of Breast Cancer Specialists recommendations for the management of young women with breast cancer. Europ J Canc. 2012;48(18):3355–3377.
Shoemaker ML, White MC, Wu M, Weir HK, Romieu I. Differences in breast cancer incidence among young women aged 20–49 years by stage and tumor characteristics, age, race, and ethnicity, 2004–2013. Breas Canc Res Treat. 2018;169:595–606.
Kang SY, Kim YS, Kim Z, et al. Breast Cancer Statistics in Korea in 2017: Data from a Breast Cancer Registry. J Breas Cancer. 2020;23(2):115–128.
Gómez-Flores-Ramos L, Álvarez-Gómez RM, Villarreal-Garza C, Wegman-Ostrosky T, Mohar A. Breast cancer genetics in young women: What do we know?. Mutat Res Rev Mutat Res. 2017;774:33–45.
Rojas K, Stuckey A. Breast cancer epidemiology and risk factors. Clin Obstet Gynec. 2016;59(4):651–672.
Thompson D, Easton DF; Breast Cancer Linkage Consortium. Cancer Incidence in BRCA1 Mutation Carriers. J Nat Can Instit. 2002;94(18):1358–1365.
Kuchenbaecker KB, Hopper JL, Barnes DR, et al.; BRCA1 and BRCA2 Cohort Consortium. Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. JAMA. 2017;317(23):2402–2416.
Chen S, Parmigiani G. Meta-analysis of BRCA1 and BRCA2 penetrance. J Clin Onc. 2007;25(11):1329–1333.
Petrie KJ, Myrtveit SM, Partridge AH, Stephens M, Stanton AL. The relationship between the belief in a genetic cause for breast cancer and bilateral mastectomy. Health Psych. 2015;34(5):473–476.
Yadav S, Reeves A, Campian S, Sufka A, Zakalik D. Preoperative genetic testing impacts surgical decision making in BRCA mutation carriers with breast cancer: a retrospective cohort analy-sis. Hered Canc Clin Prac. 2017;15:11.
Mumper J. The Pros and Cons and Genetic Testing. Partner MD. Accessed: June 9, 2022.
Donnelly LS, Watson M, Moynihan C, Bancroft E, Evans DG, Eeles R, Lavery S, Ormondroyd E. Reproductive decision-making in young female carriers of a BRCA mutation. Human Re-prod. 2013;28(4):1006–1012.
Lodder L, Frets PG, Trijsburg RW, et al. Psychological impact of re-ceiving a BRCA1/BRCA2 test result. Am J Med Genet. 2001;98(1):15–24.
Wenzel L, Osann K, Lester J, et al. Biopsychological stress factors in BRCA mutation carriers. Psychosom. 2012;53(6):582–590.
Makhnoon S, Arun B, Bedrosian I. Helping Patients Understand and Cope with BRCA Mutations. Curre Onc Rep. 2022;24(6):733–740.
Hesse-Biber S, An C. Genetic testing and post-testing decision making among BRCA-positive mutation women: A psychosocial approach. J Genet Couns. 2016;25(5):978–992.
Oliveri S, Ferrari F, Manfrinati A, Pravettoni G. A systematic review of the psychological implications of genetic testing: A comparative aanalysis among cardiovascular, neurodegenerative and cancer diseases. Front Genet. 2018;9:624.
Marteau TM, Croyle RT. The new genetics. Psychological responses to genetic testing. BMJ. 1998;316:693–696.
National Cancer Institute. Easing concerns about giving research study participants their genetic test results. 2018. Accessed: June 9, 2022.
Rusli BN, Amrina K, Trived S, Loh P, Shashi M. Construct validity and internal consistency reliability of the Malay version of the 21-item depression anxiety stress scale (Malay-DASS-21) among male outpatient clinic attendees in Johor. Med J Malaysia. 2017;72(5):264–270.
Spitzer RL, Kroenke K, Williams JB, Löwe B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archiv Inter Med. 2006;166(10):1092–1097.
Williams N. The GAD-7 questionnaire. Occup Med. 2014;64(3):224–224.
Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Person Social Psych. 1989;56(2):267–283.
Basińska M, Kasprzak A. The relationship between strategies of coping with stress and acceptance of illness among patients with psoriasis. Derm Rev. 2012;99(6):692–700.
Costa PT, McCrae RR. Four ways five factors are basic. Person Individ Differen. 1992;13(6):653–7665.
Luszczyńska A, Kowalska M, Mazurkiewicz M, Schwarzer R. Berlin social support scales (BSSS): Polish version of BSSS and preliminary results on its psychometric properties. Psych Stud. 2006;44(3):17–727.
Dwyer AA, Hesse-Biber S, Shea H, Zeng Z, Yi S. Coping response and family communication of cancer risk in men harboring a BRCA mutation: A mixed methods study. Psych Oncol. 2022;31(3):486–495.
Tai YC, Domchek S, Parmigiani G, Chen S. Breast cancer risk among male BRCA1 and BRCA2 mutation carriers. J Natl Cancer Inst. 2007;99(23):1811–1814.
Kuchenbaecker KB, Hopper JL, Barnes DR, et al. Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. JAMA. 2017;317(23):2402–72416.
Antoniou A, Pharoah PD, Narod S, et al. Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case Series unselected for family history: a combined analysis of 22 studies. Am J Hum Genet. 2003;72(5):1117–71130.
Chen S, Parmigiani G. Meta-analysis of BRCA1 and BRCA2 penetrance. J Clin Oncol. 2007; 25(11):1329–1333.
Peshkin BN, Ladd MK, Isaacs C, et al. The genetic education for men (GEM) trial: Development of web-based education for untested men in BRCA1/2-positive families. J Cancer Educ. 2021;36(1):72–84.
Kote-Jarai Z, Leongamornlert D, Saunders E, et al. BRCA2 is a moderate penetrance gene contrib-uting to young-onset prostate cancer: implications for genetic testing in prostate cancer patients. Br J Cancer. 2011;105(8):1230–1234.
Nyberg T, Tischkowitz M, Antoniou AC. BRCA1 and BRCA2 pathogenic variants and prostate cancer risk: systematic review and meta-analysis. Br J Cancer. 2022;126:1067–1081.
Rosen MN, Goodwin RA, Vickers MM. BRCA mutated pancreatic cancer: A change is coming. World J Gastroenterol. 2021;27(17):1943–1958.
Donnelly LS, Watson M, Moynihan C, et al. Reproductive decision-making in young female carriers of a BRCA mutation. Hum Reprod. 2013;28(4):1006–1012.
Roberts BW, Walton KE, Viechtbauer W. Patterns of mean-level change in personality traits across the life course: A meta-analysis of longitudinal studies. Psychol Bull. 2006;132(1):1–25.
Schmitt DP, Realo A, Voracek M, Allik J. Why can’t a man be more like a woman? Sex differences in Big Five personality traits across 55 cultures. J Pers Soc Psychol. 2008;94(1):168–182.
Hallowell N, Foster C, Ardern-Jones A, Eeles R, Murday V, Watson M. Genetic testing for women previously diagnosed with breast/ovarian cancer: examining the impact of BRCA1 and BRCA2 mutation searching. Genet Test. 2002;6(2):79–87.
Ludwig KK, Neuner J, Butler A, Geurts JL, Kong AL. Risk reduction and survival benefit of prophy-lactic surgery in BRCA mutation carriers, a systematic review. Am J Surg. 2016;212(4):660–669.
Metcalfe KA, Price MA, Mansfield C, et al. Predictors of long-term cancer-related distress among female BRCA1 and BRCA2 mutation carriers without a cancer diagnosis: an international analysis. Br J Cancer. 2020;123(2):268–274.
Hatcher MB, Fallowfield L, A'Hern R. The psychosocial impact of bilateral prophylactic mastectomy: prospective study using questionnaires and semistructured interviews. BMJ. 2001;322(7278):76.
Baker SK, Mayer DK, Esposito N. The contralateral prophylactic mastectomy decision-making process. Plast Surg Nurs. 2013;33(1):11–23.
Akhtar H. Translation and validation of the Ten-Item Personality Inventory (TIPI) into Bahasa Indonesia. Intern J Res Stud Psych. 2018;7(2):59–69.
Li M, Nishikawa T. The relationship between active coping and trait resilience across U.S. and Taiwanese college student samples. J Coll Couns. 2012;15(2):157–171.
Schulz U,Schwarzer R. Social support in coping with illness: The Berlin Social Support Scales (BSSS) [in German]. Diagnostica. 2003;49:73–82.
Preiss M, Mejzlíková T, Rudá A, Krámský D, Pitáková J. Testing the level of social desirability during job interview on white-collar profession. Front Psychol. 2015;6:1886.