{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:28:28Z","timestamp":1790011708582,"version":"4.0.1"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T00:00:00Z","timestamp":1552867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009148","name":"Queen Mary University of London","doi-asserted-by":"publisher","award":["C16420\/A18066"],"award-info":[{"award-number":["C16420\/A18066"]}],"id":[{"id":"10.13039\/100009148","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate factors affecting unselected population\u2010based<jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>testing in Ashkenazi Jews (<jats:styled-content style=\"fixed-case\">AJ<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cohort\u2010study set within recruitment to the GCaPPS trial (ISRCTN73338115).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>North London AJ population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population or sample<\/jats:title><jats:p>Ashkenazi Jews women\/men\u00a0&gt;18 years, recruited through self\u2010referral.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ashkenazi Jews women\/men underwent pre\u2010test counselling for<jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>testing through recruitment clinics (clusters). Consenting individuals provided blood samples for<jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>testing. Data were collected on socio\u2010demographic\/family history\/knowledge\/psychological well\u2010being along with benefits\/risks\/cultural influences (18\u2010item questionnaire measuring \u2018attitude\u2019). Four\u2010item Likert\u2010scales analysed initial \u2018interest\u2019 and \u2018intention\u2010to\u2010test\u2019 pre\u2010counselling. Uni\u2010 and multivariable logistic regression models evaluated factors affecting uptake\/interest\/intention to undergo<jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>testing. Statistical inference was based on cluster robust standard errors and joint Wald tests for significance. Item\u2010Response Theory and graded\u2010response models modelled responses to 18\u2010item questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Interest, intention, uptake, attitude towards<jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 935 individuals (women\u00a0=\u00a067%\/men\u00a0=\u00a033%; mean age\u00a0=\u00a053.8 (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\u00a0=\u00a015.02) years) underwent pre\u2010test genetic\u2010counselling. During the pre\u2010counselling, 96% expressed interest in and 60% indicated a clear intention to undergo<jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>testing. Subsequently, 88% opted for<jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>testing.<jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>\u2010related knowledge (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.013) and degree\u2010level education (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01) were positively and negatively (respectively) associated with intention\u2010to\u2010test. Being married\/cohabiting had four\u2010fold higher odds for<jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>testing uptake (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.009). Perceived benefits were associated with higher pre\u2010counselling odds for interest in and intention to undergo<jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>testing. Reduced uncertainty\/reassurance were the most important factors contributing to decision\u2010making. Increased importance\/concern towards risks\/limitations (confidentiality\/insurance\/emotional impact\/inability to prevent cancer\/marriage ability\/ethnic focus\/stigmatisation) were significantly associated with lower odds of uptake of<jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>testing, and discriminated between acceptors and decliners. Male gender\/degree\u2010level education (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001) had weaker correlations, whereas having children showed stronger (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.005) associations with attitudes towards<jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>testing in the<jats:styled-content style=\"fixed-case\">AJ<\/jats:styled-content>population has high acceptability. Pre\u2010test counselling increases awareness of disadvantages\/limitations of<jats:italic><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content><\/jats:italic>testing, influencing final cost\u2010benefit perception and decision\u2010making on undergoing testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">BRCA<\/jats:styled-content>testing in Ashkenazi Jews has high acceptability and uptake. Pre\u2010test counselling facilitates informed decision\u2010making.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.15654","type":"journal-article","created":{"date-parts":[[2019,2,15]],"date-time":"2019-02-15T08:52:01Z","timestamp":1550220721000},"page":"784-794","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Attitude towards and factors affecting uptake of population\u2010based<i><scp>BRCA<\/scp><\/i>testing in the Ashkenazi Jewish population: a cohort study"],"prefix":"10.1111","volume":"126","author":[{"given":"R","family":"Manchanda","sequence":"first","affiliation":[{"name":"Barts Cancer Institute Queen Mary University of London London UK"},{"name":"Department of Gynaecological Oncology St Bartholomew's Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Burnell","sequence":"additional","affiliation":[{"name":"MRC Clinical Trials Unit University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Gaba","sequence":"additional","affiliation":[{"name":"Barts Cancer Institute Queen Mary University of London London UK"},{"name":"Department of Gynaecological Oncology St Bartholomew's Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Sanderson","sequence":"additional","affiliation":[{"name":"Behavioural Sciences Unit Department of Epidemiology and Public Health University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Loggenberg","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics North East Thames Regional Genetics Unit Great Ormond Street Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Gessler","sequence":"additional","affiliation":[{"name":"MRC Clinical Trials Unit University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Wardle","sequence":"additional","affiliation":[{"name":"Behavioural Sciences Unit Department of Epidemiology and Public Health University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Side","sequence":"additional","affiliation":[{"name":"University Hospital Southampton NHS Foundation Trust Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Desai","sequence":"additional","affiliation":[{"name":"MRC Clinical Trials Unit University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AF","family":"Brady","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics North West Thames Regional Genetics Unit Northwick Park Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Dorkins","sequence":"additional","affiliation":[{"name":"St Peter's College University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Wallis","sequence":"additional","affiliation":[{"name":"West Midlands Regional Genetics Laboratory Birmingham Women's NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Chapman","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics West Midlands Regional Genetics Service Birmingham Women's NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Guy's Hospital London UK"},{"name":"University of Technology Sydney Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Tomlinson","sequence":"additional","affiliation":[{"name":"Institute of Cancer and Genomic Sciences University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U","family":"Beller","sequence":"additional","affiliation":[{"name":"Department of Gynecology Shaare Zedek Medical Center Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U","family":"Menon","sequence":"additional","affiliation":[{"name":"MRC Clinical Trials Unit University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Jacobs","sequence":"additional","affiliation":[{"name":"University of New South Wales UNSW Sydney Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju379"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1415979111"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.25.0712"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmedgenet-2015-103740"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2016.182"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0004.2010.01499.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju380"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju420"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.2217\/fon.15.278"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2016.175"},{"key":"e_1_2_6_12_1","first-page":"240","article-title":"Genetic counseling","volume":"27","author":"Epstein C","year":"1975","journal-title":"Am J Hum Genet"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10897-005-9014-3"},{"key":"e_1_2_6_14_1","unstructured":"NCI. Genetic Counselling. Cancer Genetics Overview (PDQ).2013. [http:\/\/www.cancer.gov\/cancertopics\/pdq\/genetics\/overview\/healthprofessional\/page2. Accessed 31 July 2013."},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/89.2.148"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03530480027036"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00125817-200209000-00005"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20010815)92:4<932::AID-CNCR1403>3.0.CO;2-Q"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-0004.2000.570508.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1089\/gte.2004.8.240"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2004.04.051"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.1999.0610"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.2002.1031"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.13.1.39"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/1096-8628(2000)9999:999<00::AID-AJMG1142>3.0.CO;2-I"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.85.8_Pt_1.1133"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19970110)68:1<43::AID-AJMG8>3.0.CO;2-Z"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10897-005-0384-3"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejhg.5200668"},{"key":"e_1_2_6_31_1","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1002\/pon.2106","article-title":"A follow\u2010up study on men tested for BRCA1\/BRCA2 mutations: impacts and coping processes","volume":"22","author":"Shiloh S","year":"2011","journal-title":"Psycho\u2010oncology"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1086\/316907"},{"key":"e_1_2_6_33_1","volume-title":"JPR\/Report. Key Trends in the British Jewish Community","author":"JPR","year":"2011"},{"issue":"4","key":"e_1_2_6_34_1","first-page":"369","article-title":"Attitudes and interest in genetic testing for breast and ovarian cancer susceptibility in diverse groups of women in western Washington","volume":"8","author":"Durfy SJ","year":"1999","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2003.09.012"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.var.54"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2011.29.15_suppl.1513"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.51.3226"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju328"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.65.9557"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10897-015-9836-6"},{"key":"e_1_2_6_42_1","volume-title":"Predicting Risk of Ovarian Malignancy Improved Screening and Early Detection Feasibility Study ISRCTN Registry: ISRCTN54246466","author":"Manchanda R","year":"2017"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.15654","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.15654","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.15654","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.15654","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,14]],"date-time":"2024-07-14T20:24:49Z","timestamp":1720988689000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.15654"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,18]]},"references-count":41,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1111\/1471-0528.15654"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.15654","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,18]]},"assertion":[{"value":"2018-12-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}