
Contents
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8 Cervical Cancer Screening and HPV Vaccination: Multilevel Challenges to Cervical Cancer Prevention
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Background Background
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Outline of Genetic Counseling Outline of Genetic Counseling
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Outcomes of Genetic Testing for Breast Cancer Outcomes of Genetic Testing for Breast Cancer
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Treatment-Focused Genetic Testing Treatment-Focused Genetic Testing
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The Possible Burden of Intense Surveillance and Prophylactic Surgery The Possible Burden of Intense Surveillance and Prophylactic Surgery
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Breast Cancer Surveillance Breast Cancer Surveillance
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Prophylactic Mastectomy Prophylactic Mastectomy
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Ovarian Cancer Surveillance and Risk-Reducing Salpingo-Oophorectomy Ovarian Cancer Surveillance and Risk-Reducing Salpingo-Oophorectomy
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Psychosocial Issues Encountered by Individuals Undergoing Genetic Counseling and Testing Psychosocial Issues Encountered by Individuals Undergoing Genetic Counseling and Testing
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Testing Positive for a Genetic Mutation Testing Positive for a Genetic Mutation
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Risk Factors for Increased Psychosocial Distress Risk Factors for Increased Psychosocial Distress
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Identification of Psychosocial Problems Identification of Psychosocial Problems
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Receiving a Negative Test Result Receiving a Negative Test Result
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Inconclusive Test Results Inconclusive Test Results
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Family Communication Issues Family Communication Issues
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BRCA1 and BRCA2 Carriers and Assisted Reproduction BRCA1 and BRCA2 Carriers and Assisted Reproduction
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Psychological Approaches That Support Genetic Testing Psychological Approaches That Support Genetic Testing
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Future Directions Future Directions
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References References
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16 Psychosocial Issues Related to Liquid Biopsy for ctDNA in Individuals at Normal and Elevated Risk
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13 Psychosocial Issues in Genetic Testing for Breast/Ovarian Cancer
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Published:January 2021
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Abstract
Approximately 10% of all breast cancers are due to hereditary factors, with the majority caused by mutations in two autosomal dominant breast cancer genes, BRCA1 and BRCA2. Mutations in these genes are associated with cumulative risks of breast cancer of 72% in BRCA1 mutation carriers and 69% in BRCA2 mutation carriers by age 80. Mutation carriers who develop breast cancer have elevated risk for contralateral breast cancer. BRCA1/2 mutations also place women at elevated risk for ovarian cancer. Genetic counseling and testing are available to individuals, with or without cancer, to inform health-related decision-making. While genetic knowledge offers opportunities for prevention, including prophylactic risk-reducing surgery, a number of psychological and social challenges have been identified in the BRCA1/2 population. This chapter provides a broad overview of seminal research on the psychosocial impacts of genetic testing in BRCA1/2 with the goal of helping readers better identify, evaluate, and treat psychosocial challenges stemming from the process of genetic testing. Identifiable risk factors for psychosocial distress during the genetic counseling process are summarized. The chapter points toward key psychometric instruments designed to support psychosocial screening in cancer genetic populations. Further, a summary of intervention strategies to support psychosocial adaptation to genetic testing is provided.
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