Cancer screening distress in a clinic-based population of BRCA mutation carriers.

20570 Background: Knowledge of BRCA1/2 carrier status has been linked with increased distress and health concerns in this population. Mutation carriers receive recommendations for more intensive cancer screening, which may create added stress. The purpose of this study is to identify whether there are differences in distress associated with the screening process depending on completion of prophylactic surgery (PS), and to determine whether this distress changes over time.,A longitudinal design was utilized to survey 90 physician-referred women who had previously received notice that they were BRCA1/2 mutation carriers. Patient-reported surveys were collected during the first clinic visit, and at one year follow-up for 55 women. Cancer screening distress was measured by the Impact of Event Scale. Statistical analyses included t-tests and analyses of variance for continuous variables, and chi-square tests for categorical variables.,Among 90 BRCA1 (69%) or BRCA2 (30%) carriers, 40% had a cancer history. The majority of participants were nonHispanic White women (98%) of Ashkenazi Jewish descent (76%). 37% of the total study population reported clinically significant levels of distress associated with screening, driven largely by the BRCA1 mutation carrier cohort. Those considering PS evidenced significantly more distress associated with cancer screening (p=0.05) compared to those who were not opting for PS, or those who had already had it. Within the three groups, clinically significant levels of distress were noted in 26% who did not have PS, 39% for those who had PS, and 53% for those considering a procedure. At follow-up one year later, cancer screening distress decreased only for those who had considered and subsequently underwent PS. Quality of life did not change over time.,Distress associated with the screening process was greatest for those considering surgery, but decreased sharply after the PS. Cancer screening was least distressing for those who were not considering a prophylactic procedure. Interventions should be targeted at those at greatest risk for distress. No significant financial relationships to disclose.