CDKN2A/p16 genetic test reporting improves early detection intentions and practices in high-risk melanoma families

Lisa G. Aspinwall, Samantha L. Leaf, Erin R. Dola, Wendy Kohlmann, Sancy Leachman

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Genetic testing for melanoma has yet to enter routine clinical use because of the scarcity of available data on the effect of test reporting. A prospective study of 59 members of Utah CDKN2A/p16 mutation-positive pedigrees was conducted to establish the effect of CDKN2A/p16 genetic test reporting on melanoma early detection intentions and behaviors (total body skin examination and skin self-examination) in a high-risk population. Behavioral assessments were made at baseline, immediately after CDKN2A/p16 test reporting and counseling, and at 1-month follow-up (42 participants). Baseline screening practices were poor relative to current recommendations, especially among participants without a personal history of melanoma. Changes from baseline practice were evaluated in three groups of participants (CDKN2A/p16+ with history ofmelanoma, CDKN2A/p16+ without melanoma history, and CDKN2A/p16-). Across multiple measures, test reporting caused CDKN2A/p16 mutation carriers without a melanoma history to improve to the level of adherence reported by participants with a melanoma history, without decreasing compliance of the CDKN2A/p16- group. Compared with baseline, CDKN2A/p16+ participants without a melanoma history reported greater intention to obtain total body skin examinations (P <0.0001), increased intentions and adherence to skin self-examination recommendations (P <0.01 and P <0.001, respectively), and increased number of body sites examined at 1 month (P <0.002); further, 55% reported adopting a new screening behavior at follow-up. Test reporting also improved skin self-examination adherence among CDKN2A/p16- participants (P <0.03). The finding that CDKN2A/p16 test reporting enhances compliance with early detection measures among CDKN2A/p16+ participants without diminishing the compliance of CDKN2A/p16- participants suggests a favorable risk-benefit ratio for melanoma genetic testing in high-risk patients.

Original languageEnglish (US)
Pages (from-to)1510-1519
Number of pages10
JournalCancer Epidemiology Biomarkers and Prevention
Volume17
Issue number6
DOIs
StatePublished - Jun 2008
Externally publishedYes

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Melanoma
Self-Examination
Skin
Genetic Testing
Compliance
Mutation
Pedigree
Counseling
History
Odds Ratio
Prospective Studies
Population

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

CDKN2A/p16 genetic test reporting improves early detection intentions and practices in high-risk melanoma families. / Aspinwall, Lisa G.; Leaf, Samantha L.; Dola, Erin R.; Kohlmann, Wendy; Leachman, Sancy.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 17, No. 6, 06.2008, p. 1510-1519.

Research output: Contribution to journalArticle

Aspinwall, Lisa G. ; Leaf, Samantha L. ; Dola, Erin R. ; Kohlmann, Wendy ; Leachman, Sancy. / CDKN2A/p16 genetic test reporting improves early detection intentions and practices in high-risk melanoma families. In: Cancer Epidemiology Biomarkers and Prevention. 2008 ; Vol. 17, No. 6. pp. 1510-1519.
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abstract = "Genetic testing for melanoma has yet to enter routine clinical use because of the scarcity of available data on the effect of test reporting. A prospective study of 59 members of Utah CDKN2A/p16 mutation-positive pedigrees was conducted to establish the effect of CDKN2A/p16 genetic test reporting on melanoma early detection intentions and behaviors (total body skin examination and skin self-examination) in a high-risk population. Behavioral assessments were made at baseline, immediately after CDKN2A/p16 test reporting and counseling, and at 1-month follow-up (42 participants). Baseline screening practices were poor relative to current recommendations, especially among participants without a personal history of melanoma. Changes from baseline practice were evaluated in three groups of participants (CDKN2A/p16+ with history ofmelanoma, CDKN2A/p16+ without melanoma history, and CDKN2A/p16-). Across multiple measures, test reporting caused CDKN2A/p16 mutation carriers without a melanoma history to improve to the level of adherence reported by participants with a melanoma history, without decreasing compliance of the CDKN2A/p16- group. Compared with baseline, CDKN2A/p16+ participants without a melanoma history reported greater intention to obtain total body skin examinations (P <0.0001), increased intentions and adherence to skin self-examination recommendations (P <0.01 and P <0.001, respectively), and increased number of body sites examined at 1 month (P <0.002); further, 55{\%} reported adopting a new screening behavior at follow-up. Test reporting also improved skin self-examination adherence among CDKN2A/p16- participants (P <0.03). The finding that CDKN2A/p16 test reporting enhances compliance with early detection measures among CDKN2A/p16+ participants without diminishing the compliance of CDKN2A/p16- participants suggests a favorable risk-benefit ratio for melanoma genetic testing in high-risk patients.",
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