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. 2014 Nov;16(11):846-53.
doi: 10.1038/gim.2014.37. Epub 2014 Apr 24.

Unaffected family members report improvements in daily routine sun protection 2 years following melanoma genetic testing

Lisa G Aspinwall  1 , Jennifer M Taber  1 , Wendy Kohlmann  2 , Samantha L Leaf  1 , Sancy A Leachman  3
Affiliations

Unaffected family members report improvements in daily routine sun protection 2 years following melanoma genetic testing

Lisa G Aspinwall et al. Genet Med. 2014 Nov.

Abstract

Purpose: Reducing ultraviolet radiation exposure may decrease melanoma risk in the hereditary melanoma setting. It is unknown whether genetic counseling and test reporting of CDKN2A/p16 mutation status promote long-term compliance with photoprotection recommendations, especially in unaffected mutation carriers.

Methods: This study evaluated changes 2 years following melanoma genetic testing in self-reported practice of sun protection (sunscreen, photoprotective clothing, and ultraviolet radiation avoidance) among 37 members of two CDKN2A/p16 kindreds (10 unaffected carriers, 11 affected carriers, and 16 unaffected noncarriers; response rate = 64.9% of eligible participants).

Results: Multivariate profile analysis indicated that all three participant groups reported increased daily routine practice of sun protection 2 years following melanoma genetic testing (P < 0.02), with 96.9% reporting that at least one sun protection behavior was part of their daily routine, up from 78.1% at baseline (P < 0.015). Unaffected carriers (P < 0.024) and unaffected noncarriers (P < 0.027) reported significantly more frequent use of photoprotective clothing. Affected carriers maintained adherence to all sun protection behaviors. Reported sunburns in the past 6 months decreased significantly (P < 0.018).

Conclusion: Members of high-risk families reported increased daily routine sun protection and decreased sunburns 2 years following melanoma genetic testing, with no net decline in sun protection following negative test results. Thus, genetic testing and counseling may motivate sustained improvements in prevention behaviors.

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Conflict of interest statement

For conflict of interest, see separate document.

Figures

Figure 1
Figure 1
Recruitment, retention, and attrition of noncarriers, unaffected carriers, and affected carriers at baseline and 2-year follow-up. a One began study participation after the seasonal cutoff date (an eligibility criterion intended to provide seasonal adjustment for measures of photoprotection). The other two were not invited to the follow-up study because one participant was adopted and the other was from a small kindred. Given the focus on family communication and other familial issues in other parts of the questionnaire, it was decided that these participants' experience with genetic counseling and test reporting would be substantially different from the experiences of other participants. b Retention rates for the 2-year follow-up assessment were calculated out of the 57 eligible participants (26 unaffected noncarriers, 15 unaffected carriers, and 16 affected carriers) who were invited to the follow-up study.
Figure 2
Figure 2
Percent of time in the past 6 months participants reported using each of the recommended sun-protection behaviors (using sunscreen, wearing protective clothing, avoiding peak UVR exposure, seeking shade) at baseline and 2 years following melanoma genetic test reporting for A) unaffected noncarriers, B) unaffected carriers, and C) affected carriers. *p<.05, ^p<.10
Figure 3
Figure 3
Reported daily routine use of sunscreen, protective clothing, and UVR avoidance at baseline and 2 years following melanoma genetic test reporting for A) unaffected noncarriers, B) unaffected carriers, and C) affected carriers. *p<.05 ^p<.10
See this image and copyright information in PMC

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