Project: Research project

Project Details


The main goal of this proposal is to develop appropriate comprehensive
counseling guidelines for predictive colon cancer gene testing by: (1)
assessing perceptions and attitudes toward the gene tests, including their
social and psychological determinants, and (2) assessing the impact of the
test on at-risk persons. Our specific aims are: 1. To characterize in at-risk individuals those psychosocial factors that
predict willingness to undergo genetic testing for colon cancer, to
determine projected uses that will be made of the gene test, and to
determine the influence of social context, primarily family culture, in
shaping at-risk individuals' attitudes toward and perceptions of the gene
test. This will be accomplished by a mail survey of 1,000 adults at risk
for colon cancer. 2. To compare attitudes toward and perceptions of genetic testing for
colon cancer between white and African-American individuals (and a
subsample of their families). This will be accomplished with the mail
survey data and by qualitative telephone interviews with members of 50
families (25 white, 25 African-American) sampled from the mail survey. 3. To identify predictors of psychological distress associated with pre-
and post-disclosure cancer risk perception based on: experiences with
cancer, knowledge/beliefs/feelings about cancer, implicit models of
illness regarding cancer, cancer risk perceptions, coping behaviors, and
tolerance for ambiguity. We will offer MSH2 and MLH1 gene tests to 200
individuals at high risk for colon cancer, based on family history. Data
will be collected by questionnaire and interviews before and after gene
testing (at one month, six months, and one year post disclosure). The gene
test will result in one of three possible outcomes: definite gene-
positive, definite gene-negative, and inconclusive gene-negative. The
first two outcomes are expected when the mutation in the family is known;
the last outcome may occur when the mutation is not known, but the family
history is strongly suggestive of hereditary colon cancer. We will
stratify on the three outcomes and compare pre- and post disclosure
measures of distress and attitudes. 4. To assess post disclosure prevention-oriented health behaviors among
persons receiving gene positive, gene negative and inconclusive test
results. Because screening recommendations may vary with age, we will
stratify our analyses by age groups as well as gene test outcome.
Effective start/end date9/30/945/31/03


  • National Institutes of Health: $272,902.00
  • National Institutes of Health: $281,976.00
  • National Institutes of Health
  • National Institutes of Health


  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)


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