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 language | English (US) |
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Pages (from-to) | 1510-1519 |
Number of pages | 10 |
Journal | Cancer Epidemiology Biomarkers and Prevention |
Volume | 17 |
Issue number | 6 |
DOIs | |
State | Published - Jun 2008 |
Externally published | Yes |
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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 journal › Article
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TY - JOUR
T1 - CDKN2A/p16 genetic test reporting improves early detection intentions and practices in high-risk melanoma families
AU - Aspinwall, Lisa G.
AU - Leaf, Samantha L.
AU - Dola, Erin R.
AU - Kohlmann, Wendy
AU - Leachman, Sancy
PY - 2008/6
Y1 - 2008/6
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=53349090631&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=53349090631&partnerID=8YFLogxK
U2 - 10.1158/1055-9965.EPI-08-0010
DO - 10.1158/1055-9965.EPI-08-0010
M3 - Article
C2 - 18559569
AN - SCOPUS:53349090631
VL - 17
SP - 1510
EP - 1519
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
SN - 1055-9965
IS - 6
ER -