Melanoma Genetic Testing, Counseling, and Adherence to Skin Cancer Prevention and Detection Behaviors.

Glanz KL, Volpicelli K, Kanetsky PA, Ming ME, Schuchter LM, Jepson C, Domchek SM, Armstrong K.

Source

1Schools of Medicine and Nursing, University of Pennsylvania.

Abstract

BACKGROUND:

Little is known about the impact of knowledge of CDKN2A and MC1R genotype on melanoma prevention behaviors like sun avoidance and skin examination in the context of familial melanoma.

METHODS:

A total of 73 adults with a family history of melanoma were randomly assigned to be offered individualized CDKN2A and MC1R genotyping results in the context of a genetic counseling session, or the standard practice of not being offered counseling or disclosure of genotyping results. Mixed effects or longitudinal logistic models were used to determine whether the intervention affected change in sun protection habits, skin examinations and perception and beliefs related to melanoma risk, prevention, and genetic counseling.

RESULTS:

All participants in the intervention group who attended genetic counseling sessions chose to receive their test results. From baseline to follow-up, participants in the intervention group reported an increase in the frequency of skin self-examinations compared to a slight decrease in the control group (p=0.002). Participants in the intervention group reported a smaller decrease in frequency of wearing a shirt with long sleeves than did participants in the control group (p =0.047). No effect of the intervention was noted for other outcomes.

CONCLUSIONS:

It is noteworthy that feedback of CDKN2A and MC1R genotype among families without known pathogenic CDKN2A mutations does not appear to decrease sun protection behaviors. Because of the limited number of families with known pathogenic CDKN2A mutations in this study, it is difficult to interpret the results as demonstrating a positive benefit of the intervention.