Long-term psychosocial and behavioral adjustment in individuals receiving genetic test results in Lynch syndrome

Abstract

A cross-sectional study of 155 participants who underwent genetic testing for Lynch syndrome (LS) examined long-term psychosocial and behavioral outcomes. Participants completed standardized measures of perceived risk, psychosocial functioning, knowledge, and a questionnaire of screening activities. Participants were on average 47.3 years and had undergone testing a mean of 5.5 years prior. Eighty four (54%) tested positive for a LS mutation and 71 (46%) negative. For unaffected carriers, perceived lifetime risk of colorectal cancer was 68%, and surprisingly, 40% among those testing negative. Most individuals demonstrated normative levels of psychosocial functioning. However, 25% of those testing negative had moderate depressive symptoms, as measured by the Center for Epidemiologic Studies for Depression Scale, and 31% elevated state anxiety on the State-Trait Anxiety Inventory. Being female and a stronger escape - avoidant coping style were predictive of depressive symptoms. For state anxiety, similar patterns were observed. Quality of life and social support were significantly associated with lower anxiety. Carriers maintained higher knowledge compared to those testing negative, and were more engaged in screening. In summary, most individuals adapt to genetic test results over the long term and continue to engage in screening. A subgroup, including some non-carriers, may require added psychosocial support.

Keywords: Lynch syndrome; colorectal cancer; empirical study; genetic testing; long-term follow-up; psychological adjustment; screening and knowledge.

Figure 1. Perceived percentage lifetime risk of developing CRC (0 – 100%) by carrier status at risk positive versus negative (n = 112)

t = 5.3, df = 110, p < 0.01

Figure 2. Hereditary CRC knowledge by test result and cancer status

t = 3.1, df = 110, P < 0.01