{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:47:00Z","timestamp":1792100820312,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In the UK's National Health Service (NHS), there is specific psychosocial care offered to people with genetic cancer risk conditions but not morphological cancer risk conditions. As researchers develop new ways to diagnose morphological risk conditions, including precancers and in\u00a0situ cancers, it is important to consider the psychosocial care that those diagnosed might require.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study compares the National Institute for Health and Care Excellence's guidelines for BRCA1\/2, which are genetic risk conditions, and Barrett's oesophagus (BO), a morphological risk condition. It then theorises reasons for the similarities and differences made visible by this comparative work.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The author completed an in\u2010depth analysis of two sets of NICE guidelines, before carrying out a review of historical and social scientific literature on cancer risk to offer potential explanations for the disparities identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The \u2018right not to know\u2019 is protected in the case of BRCA1\/2 diagnoses, but not BO. Additionally, specialist counselling is required for people receiving diagnoses of genetic risk but not offered for those diagnosed with morphological risk conditions. The paper offers four possible reasons for these disparities, concluding that they appear to be in large part due to historic genetic exceptionalism, rather than differences in patients' needs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There may be a need to consider offering further psychosocial care to people with morphological risk conditions like BO. Lessons might be learnt from the field of genetic counselling.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.70607","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T10:51:15Z","timestamp":1736938275000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["\u2018Why Don't We Get Counselling?\u2019: Comparing <scp>NICE<\/scp> Guidelines for Morphological and Genetic Cancer Risk Diagnoses"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3499-681X","authenticated-orcid":false,"given":"Elspeth","family":"Davies","sequence":"first","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"e_1_2_15_2_1","volume-title":"The NHS Long Term Plan","author":"Department of Health","year":"2019"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7311.514"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13053-017-0077-6"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12817"},{"key":"e_1_2_15_6_1","doi-asserted-by":"crossref","unstructured":"N.HoltzmanandM.Watson \u201cPromoting Safe and Effective Genetic Testing in the United States: Final Report of the Task Force on Genetic Testing \u201d (1999) https:\/\/www.genome.gov\/10001733\/genetic\u2010testing\u2010report.","DOI":"10.56021\/9780801859526"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(17)30213-3"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.02.024"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2015.33.15_suppl.e12522"},{"key":"e_1_2_15_10_1","unstructured":"NICE \u201cFamilial Breast Cancer: Classification Care and Managing Breast Cancer and Related Risks in People With a Family History of Breast Cancer. Guidance \u201d2013 https:\/\/www.nice.org.uk\/guidance\/cg164."},{"key":"e_1_2_15_11_1","unstructured":"Barrett's Oesophagus and Stage 1 Oesophageal Adenocarcinoma: Monitoring and Management 2023 https:\/\/www.nice.org.uk\/guidance\/ng231."},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-2176-2440"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17283"},{"key":"e_1_2_15_14_1","unstructured":"Specialised Commissioning Team NHS England \u201cE01\/P\/b BRCA Testing for BRCA Mutations in Breast and Ovarian Cancer \u201d (2015) https:\/\/www.england.nhs.uk\/wp\u2010content\/uploads\/2018\/07\/Genetic\u2010testing\u2010for\u2010BRCA1\u2010and\u2010BRCA2\u2010mutations.pdf."},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i28.9611"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgast-2022-001091"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2019.05.007"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/01459740.2024.2376004"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60487-6"},{"key":"e_1_2_15_20_1","first-page":"241","volume-title":"Cancer in the Twentieth Century","author":"L\u00f6wy I.","year":"2008"},{"key":"e_1_2_15_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-010-0934-4"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.1997.7.369"},{"key":"e_1_2_15_23_1","first-page":"565","article-title":"Foreward: Genetic Exceptionalism","volume":"11","author":"McGee G.","year":"1998","journal-title":"Harvard Journal of Law & Technology"},{"key":"e_1_2_15_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/jme\u20102024\u2010109928"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.70607","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T22:11:49Z","timestamp":1744927909000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.70607"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/cam4.70607"],"URL":"https:\/\/doi.org\/10.1002\/cam4.70607","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-11-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70607"}}