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  The Digital Collegian - Published independently by students at Penn State
SCIHEALTH
[ Tuesday, Oct. 5, 2004 ]

New software helps inform women of cancer risks
Developed by a Penn State professor, it advises users about genetic testing.

Collegian Staff Writer

The results of a recent study confirmed the effectiveness of an interactive computer program intended to educate women about breast cancer.

Michael Green, associate professor of humanities and medicine at the Penn State College of Medicine and developer of a new software called Breast Cancer Risk and Genetic Testing, said he wanted to design a program to help women learn about their genetic risk factor for getting breast cancer.

The program helps women make choices about whether to seek out a genetic counselor and genetic testing based on reliable information, "having them explore what's important to them," Green said.

Genetic testing raises complicated issues people need to know about, Green said. Breast Cancer Risk and Genetic Testing helps users decide whether they want to get tested, he said.

To evaluate the program's effectiveness, 211 volunteers with personal or family histories of breast cancer were divided into two groups. One group only saw a genetic counselor. The other group used the computer program before meeting with a counselor.

"I think it is a wonderful educational tool that at this point in time I don't think is being used to its fullest potential," said Maria Baker, a genetics counselor and medical geneticist at the Penn State Cancer Institute, who worked on the study.

According to the study, low-risk women who used the computer program improved their knowledge more so than those who only met with genetic counselors. Though both were effective, Green said he was somewhat surprised by this finding.

In the context of the study, low- and high-risk refer to a woman's likelihood of carrying the BRCA1 or BRCA2 gene mutation, he said. However, some people may be at low risk for carrying a mutation but still be at high risk for developing cancer, Green said.

BRCA1 and BRCA2 are the first and second genes discovered to be predisposed to breast cancer, Baker said.

"There is no question that certain kinds of family history [are] significant," said Margaret Spear, director of University Health Services.

Although it is important, it's dangerous to assume that knowing risk is enough to determine whether a person will get breast cancer, Spear said.

Family history of breast cancer, especially the onset of cancer before age 50, family history of ovarian cancer, incidents of related men who had breast cancer and an Ashkenazi Jewish background are factors to consider when evaluating the risk for carrying a genetic mutation, Baker said.

Correct response comparison graphic
GRAPHIC: Andrew Lashin/Collegian
SOURCE: Journal of the American Medical Association

Menstrual history and the number of children a woman has bore also factor into whether a woman has a mutation, Green said.

The computer program allows people as much time as they need, at their own convenience, to learn about breast cancer risk and genetic testing, Baker said. Women can learn from the program and raise concerns to a physician, she said.

"[It's] getting information out to a broader group of people," Baker said.

Green said that program users can get questions answered without feeling embarrassed and go back to reread information. The program evaluates what people understand by quizzing users on what they have read, he said.

The small number of genetic counselors available cannot meet the needs of all women who have family histories of breast cancer, Green said. When people use the program in conjunction with counseling, it can make time spent with a counselor more efficient, he said.

According to the study, neither the computer program nor the genetic counselors raised participants' anxiety levels. However, the program failed to lower anxiety levels, whereas the counselors could, Green said.

Breast Cancer Risk and Genetic Testing can only give a general sense of whether women are at risk; it cannot do individualized risk assessment, Baker said.

The computer program may be more sufficient for those at low-risk, Green said, because women at high-risk need to discuss genetic testing with a counselor.

Genetic counselors can help women at high-risk develop a cancer management strategy at a more treatable stage, Baker said. Although patients are informed that genetic testing is not 100 percent accurate, it can relieve anxiety and give some people peace of mind, she said.

Some women say "knowing is better than not," one way or the other, Baker said.

"[Early detection] can make the world of difference," she said.

If you catch the cancer at a noninvasive stage, it is potentially curable, Baker said.

Green said he hopes women will eventually have access to the program at primary care facilities. Many genetic counselors have bought the program and use it with clients, he said.

Getting the program online is another long-term objective, he said.

Copies of the Breast Cancer Risk and Genetic Testing CD-ROM are available through Medical Audio Visual Communications, Inc.

 



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