{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:47:46Z","timestamp":1786978066952,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003093","name":"Ministry of Higher Education, Malaysia","doi-asserted-by":"publisher","award":["UM.C\/HIR\/MOHE\/06"],"award-info":[{"award-number":["UM.C\/HIR\/MOHE\/06"]}],"id":[{"id":"10.13039\/501100003093","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019524","name":"Yayasan Sime Darby","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019524","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Genetic Counseling"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cascade testing for families with BRCA pathogenic variants is important to identify relatives who are carriers. These relatives can benefit from appropriate risk management and preventative strategies arising from an inherited increased risk of breast, ovarian, prostate, melanoma, and pancreatic cancers. Cascade testing has the potential to enable cost\u2010effective cancer control even in low\u2010 and middle\u2010income settings, but few studies have hitherto evaluated the psychosocial impact of cascade testing in an Asian population, where the cultural and religious beliefs around inheritance and destiny have previously been shown to influence perception and attitudes toward screening. In this study, we evaluated the short\u2010 and long\u2010term psychosocial impact of genetic testing among unaffected relatives of probands identified through the Malaysian Breast Cancer Genetics Study and the Malaysian Ovarian Cancer Study, using validated questionnaires (Hospital Anxiety and Depression Scale and Cancer Worry Scale) administered at baseline, and 1\u2010month and 2\u2010year post\u2010disclosure of results. Of the 305 unaffected relatives from 98 independent families who were offered cascade testing, 256 (84%) completed predictive testing and family history of cancers was the only factor significantly associated with uptake of predictive testing. We found that the levels of anxiety, depression, and cancer worry among unaffected relatives decreased significantly after result disclosure and remained low 2\u2010year post\u2010result disclosure. Younger relatives and relatives of Malay descent had higher cancer worry at both baseline and after result disclosure compared to those of Chinese and Indian descent, whereas relatives of Indian descent and those with family history of cancers had higher anxiety and depression levels post\u2010result disclosure. Taken together, the results from this Asian cohort highlight the differences in psychosocial needs in different communities and inform the development of culture\u2010specific genetic counseling strategies.<\/jats:p>","DOI":"10.1002\/jgc4.1619","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T08:49:32Z","timestamp":1659343772000},"page":"43-56","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of\n                    <i>BRCA1\/2<\/i>\n                    cascade testing on anxiety, depression, and cancer worry levels among unaffected relatives in a multiethnic Asian cohort"],"prefix":"10.1002","volume":"32","author":[{"given":"Heamanthaa","family":"Padmanabhan","sequence":"first","affiliation":[{"name":"Cancer Research Malaysia  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivaani","family":"Mariapun","sequence":"additional","affiliation":[{"name":"Cancer Research Malaysia  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheau\u2010Yee","family":"Lee","sequence":"additional","affiliation":[{"name":"Cancer Research Malaysia  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur\u00a0Tiara","family":"Hassan","sequence":"additional","affiliation":[{"name":"Cancer Research Malaysia  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne Shin\u2010Chi","family":"Lee","sequence":"additional","affiliation":[{"name":"Cancer Research Malaysia  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Meiser","sequence":"additional","affiliation":[{"name":"Psychosocial Research Group, Prince of Wales Clinical School University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siu\u2010Wan","family":"Wong","sequence":"additional","affiliation":[{"name":"Cancer Research Malaysia  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong\u2010Quan","family":"Lee","sequence":"additional","affiliation":[{"name":"Cancer Research Malaysia  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng\u2010Har","family":"Yip","sequence":"additional","affiliation":[{"name":"Subang Jaya Medical Centre  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo\u2010Hwang","family":"Teo","sequence":"additional","affiliation":[{"name":"Cancer Research Malaysia  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meow\u2010Keong","family":"Thong","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Genetic Medicine Unit, Faculty of Medicine University Malaya Medical Centre  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur\u00a0Aishah Mohd","family":"Taib","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine University Malaya Medical Centre  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9992-0901","authenticated-orcid":false,"given":"Sook\u2010Yee","family":"Yoon","sequence":"additional","affiliation":[{"name":"Cancer Research Malaysia  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1023\/B:FAME.0000039863.89137.f9"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10865\u2010019\u201000130\u20104"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369\u20107625.2008.00494.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/1096\u20108628(20000814)93:4<257::aid\u2010ajmg1>3.0.co;2\u20108"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022\u20103999(01)00296\u20103"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1913948"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10897\u2010015\u20109845\u20105"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10897\u2010005\u20101371\u20104"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764\u2010008\u20100077\u20107"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2021.0001"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2015.12.020"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des441"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/gtmb.2008.0126"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20661"},{"key":"e_1_2_10_16_1","unstructured":"Facing Our Risk of Cancer Empowered. 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