Burnell, Matthew;
Gaba, Faiza;
Sobocan, Monika;
Desai, Rakshit;
Sanderson, Saskia;
Loggenberg, Kelly;
Gessler, Sue;
... Manchanda, Ranjit; + view all
(2022)
Randomised trial of population based BRCA testing in Ashkenazi Jews: Long term secondary lifestyle behavioural outcomes.
BJOG: An International Journal of Obstetrics & Gynaecology
, 129
(12)
pp. 1970-1980.
10.1111/1471-0528.17253.
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Abstract
Objective: Ashkenazi-Jewish(AJ) population-based BRCA-testing is acceptable, cost-effective and amplifies primary prevention for breast-&-ovarian cancer. However, data describing lifestyle impact are lacking. We report long-term results of population-based BRCA-testing on lifestyle behaviour and cancer-risk perception. // Design: Two-arm RCT (ISRCTN73338115, GCaPPS): (a)Population-Screening (PS); (b)family-history (FH)/Clinical-criteria testing. // Setting: North-London AJ-population // Population/Sample: AJ women/men >18-years. Exclusions: prior BRCA-testing or first-degree-relatives of BRCA-carriers. // Methods: Participants were recruited through self-referral. All participants received informed pre-test genetic-counselling. The intervention included genetic-testing for three AJ BRCA-mutations: 185delAG(c.68_69delAG), 5382insC(c.5266dupC) and 6174delT(c.5946delT). This was undertaken for all participants in the PS-arm; and participants fulfilling FH/clinical-criteria in the FH-arm. Patients filled customised/validated questionnaires at baseline/1-year/2-years/3-years follow-up. Generalized linear-mixed models adjusted for covariates and appropriate contrast-tests were used for between-group/within-group analysis of lifestyle and behavioural outcomes along-with evaluating factors associated with these outcomes. Outcomes are adjusted for multiple testing (Bonferoni method), with p<0.0039 considered significant. // Outcome Measures: Lifestyle/behavioural outcomes at baseline/1-year/2-years/3-years follow-up. // Results: 1034 participants were randomized to PS(n=530) or FH(n=504) arms. No significant difference was identified between PS and FH-based BRCA-testing approaches for dietary fruit/vegetable/meat consumption, vitamin intake, alcohol quantity/ frequency, smoking behaviour (frequency/cessation), physical activity/exercise or routine breast mammogram screening behaviour, with outcomes not affected by BRCA test result. Cancer-risk perception decreased with time following BRCA-testing with no difference between FH/PS approaches, and risk lowest in BRCA-negative participants. Men consume fewer fruits/vegetables/vitamins and more meat/alcohol than women (p<0.001). // Conclusion: Population-based and FH-based AJ BRCA-testing have similar long-term life-style impacts for smoking, alcohol, dietary fruit/vegetable/meat/vitamin, exercise, breast screening participation and reduced cancer-risk perception.
| Type: | Article |
|---|---|
| Title: | Randomised trial of population based BRCA testing in Ashkenazi Jews: Long term secondary lifestyle behavioural outcomes |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/1471-0528.17253 |
| Publisher version: | https://doi.org/10.1111/1471-0528.17253 |
| Language: | English |
| Additional information: | This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.© 2022 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd. |
| Keywords: | Ashkenazi Jews, BRCA1/BRCA2, cancer risk, genetic testing, lifestyle, population testing |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10151244 |
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