Clinical, sociodemographic and behavioral indicators in Genetic Counseling in Oncology.
genetic counseling; oncogenetics; hereditary cancer;
Genetic counseling (GC) has become a pivotal health preventive strategy service to manage high-risk patients for hereditary cancer in the genomic era. Identifying high-risk cancer variants in asymptomatic carriers and controlling their risk has been shown to reduce breast cancer and mortality. Brazil is a continental middleincome country with an admixture population that are suggested to have the highest internal genetic variation of sampled populations. The present study aims to evaluate clinical, sociodemographic and behavioral indicators in high-risk patients undergoing GC for hereditary cancer since 2009, in a cancer care hospital. The service has received 139 patients, where 63.3% of patients did not have higher education, 69.3% had less than 60 y; 91% had breast cancer as a primary diagnosis and 23.7% carries a germline variant in high-risk genes. The 5 years overall survival was 88.6%, with no significant difference between patients with germline mutation (95% CI, p = 0.138). After GC, 90.9% and 73.3% of the patients had mild/normal score for depression and anxiety, respectively, and regardless of age at diagnosis. Moreover, the decision of undergoing risk-reducing mastectomy (RRM) was not influenced by the depressive or anxious symptoms. However, 44.4% of women aged more than 60y did not present willingness to undergo RRM. Among patients with pathogenic variant, 58% state that the diagnosis of germline mutation was able to modify unhealth habits, 91.7% of the women could understand the meaning of germline mutation and the implications to their and family’s health, however, this was directly related to the education level. These results reaffirm the challenges of GC in an underdeveloped region of the country with high parental consanguinity, phenotypic heterogeneity and highlight the cancer health disparity that exists for the high-risk population.