Genetic counselling for breast and ovarian cancer: Why do women attend?
Statham H., Green J., Hallowell N., Murton F., Richards M.
There is a growing demand for and provision of genetic counselling for women who believe their family history of breast and/or ovarian cancer puts them at increased likelihood of developing the disease. Indeed many women in such families believe that such an eventuality is a near certainty. In this paper we will describe why women from such families attend genetic counselling sessions. The data derive from interviews with 35 women before they attended a family history clinic. Women in this study expected that their consultation would address a wide range of issues, including the significance of the cancers in their family for themselves and other family members, access to screening, genetic testing, hormone intake and reassurance. They did not often seek to discuss reproductive options although the implications for their daughters of being at- risk is important for many women. Most believed that they were more likely to develop cancer than the general population but did not consider their own risk in numerical terms. Women with a family history of cancer can, at present, only be given risks that are based on assumptions about whether or not there is a faulty gene in their family and whether or not they have inherited it. They are however, attending clinics at a time of many technical developments such that genetic testing may become available. While previously many of the women attending family history clinics were directly self-referred or there to help in research studies, many of those attending now are there at the instigation of another clinician. Some were referred for genetic advice having sought screening while others were referred without having made any request for information or advice. Women's stated reasons for attending clinic and their beliefs about their own risk were, however, unrelated to how they came to be referred to the clinic.