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Grant Details

Grant Number: 5R01CA137625-05 Interpret this number
Primary Investigator: Tercyak, Kenneth
Organization: Georgetown University
Project Title: Adolescents' Long-Term Adaptation to Familial Cancer Risks
Fiscal Year: 2014


DESCRIPTION (provided by applicant): Upwards of 25% of women surviving with breast cancer are simultaneously mothering a child under the age of 18. Maternal cancer disturbs normal parenting routines, increases family stress, and contributes to stress among offspring. Adolescent girls are especially vulnerable to maternal breast cancer occurrence, with attendant elevations in anxiety/depression. Mothers' own distress surrounding their breast cancer plays a central role in these outcomes, extending into survivorship. Presently, little is known about the psychosocial impact on adolescents of maternal breast cancer "previvorship"--a lay term describing women at high risk for developing breast cancer owing to family history and genetic status. Over 100,000 women have been tested for mutations in the 2 major breast cancer risk-conferring genes BRCA1 and BRCA2 (BRCA1/2), making life- altering decisions based upon this information. Biological children of women carrying BRCA1/2 mutations have a 50% chance of inheriting the risk-conferring mutation themselves, dramatically increasing their lifetime risk of developing breast cancer. Our work in this area indicates that even though adolescents are not yet age- eligible for BRCA1/2 cancer genetic testing, >70% are told about their mothers' genetic test result and familial cancer risk. There is a dearth of information on the long-term outcomes of adolescents learning this news on their cancer-related behaviors and cognitions, quality of life, and identity. Research suggests genetic information may foster unique responses among family members, shape perceptions of disease risk, and heighten disease-related worries. These issues take on great significance when the focus is children: knowledge of familial cancer risk information may affect developing adolescents' sense of self, worry about cancer, and create misperceptions about their own cancer risk elevations. This issue has been overlooked in the behavioral cancer control literature. In light of these issues, the primary aim of this study is to deepen our understanding of the long-term outcomes of disclosing familial cancer risk information to adolescents. We will accomplish this goal by conducting a mixed-methods, cross-sectional investigation of public health issues pertinent to cancer prevention and development among adolescents: cancer-related behaviors and cognitions, quality of life, and identity. These outcomes will be examined in a large, stratified sample of adolescents of mothers who participated in BRCA1/2 genetic testing 1-5 years previously and all of whom disclosed their genetic test results to their children. Incorporating maternal breast cancer un/affected status with BRCA test results into the study design affords us the opportunity to develop and strongly evaluate coherent, familial cancer risk-based hypotheses about adolescent psychosocial development in this context. Hypotheses will be tested in multivariate analyses guided by a family ecology, family systems, and stress-coping frameworks which comprehensively address public health translations of genomic conditions. Findings are expected to contribute to knowledge of long-term adolescent psychosocial and behavioral adaptation, and lay the groundwork for intervention with this growing population.


Cancer genetic health communication in families tested for hereditary breast/ovarian cancer risk: a qualitative investigation of impact on children's genetic health literacy and psychosocial adjustment.
Authors: Tercyak K.P. , Bronheim S.M. , Kahn N. , Robertson H.A. , Anthony B.J. , Mays D. , O'Neill S.C. , Peterson S.K. , Miesfeldt S. , Peshkin B.N. , et al. .
Source: Translational behavioral medicine, 2019-05-16; 9(3), p. 493-503.
PMID: 31094441
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Maternal perceptions of BRCA genetic counseling communication processes about disclosing cancer risk information to children and adult relatives.
Authors: Hamilton J.G. , Peshkin B.N. , Mays D. , DeMarco T.A. , Patenaude A.F. , Tercyak K.P. .
Source: Psycho-oncology, 2018 07; 27(7), p. 1825-1832.
EPub date: 2018-05-22.
PMID: 29645321
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Pediatric Predispositional Genetic Risk Communication: Potential Utility for Prevention and Control of Melanoma Risk as an Exemplar.
Authors: Wu Y.P. , Mays D. , Kohlmann W. , Tercyak K.P. .
Source: Journal of genetic counseling, 2017 Oct; 26(5), p. 887-893.
EPub date: 2017-05-25.
PMID: 28547663
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Effects of undergoing multiplex genetic susceptibility testing on parent attitudes towards testing their children.
Authors: Madeo A.C. , Tercyak K.P. , Tarini B.A. , McBride C.M. .
Source: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2014 Jun; 47(3), p. 388-94.
PMID: 24338635
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Psychometric properties of the Pediatric Testing Attitudes Scale-Diabetes (P-TAS-D) for parents of children undergoing predictive risk screening.
Authors: Tercyak K.P. , Mays D. , Johnson S.B. , Ludvigsson J. , Swartling U. .
Source: Pediatric diabetes, 2013 Dec; 14(8), p. 602-10.
EPub date: 2013-06-14.
PMID: 23763537
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Behavioral Science Research Informs Bioethical Issues in the Conduct of Large-Scale Studies of Children's Disease Risk.
Authors: Tercyak K.P. , Swartling U. , Mays D. , Johnson S.B. , Ludvigsson J. .
Source: AJOB primary research, 2013-01-01; 4(3), p. 4-14.
PMID: 23977442
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A coreceptor-independent transgenic human TCR mediates anti-tumor and anti-self immunity in mice.
Authors: Mehrotra S. , Al-Khami A.A. , Klarquist J. , Husain S. , Naga O. , Eby J.M. , Murali A.K. , Lyons G.E. , Li M. , Spivey N.D. , et al. .
Source: Journal of immunology (Baltimore, Md. : 1950), 2012-08-15; 189(4), p. 1627-38.
EPub date: 2012-07-13.
PMID: 22798675
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Results of an online community needs assessment for psychoeducational interventions among partners of hereditary breast cancer previvors and survivors.
Authors: Tercyak K.P. , Mays D. , DeMarco T.A. , Sharff M.E. , Friedman S. .
Source: Journal of medical Internet research, 2012-01-18; 14(1), p. e15.
EPub date: 2012-01-18.
PMID: 22257650
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Commentary: Children and predictive genomic testing: disease prevention, research protection, and our future.
Authors: Tarini B.A. , Tercyak K.P. , Wilfond B.S. .
Source: Journal of pediatric psychology, 2011 Nov-Dec; 36(10), p. 1113-21.
EPub date: 2011-08-04.
PMID: 21816897
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Parents' attitudes toward pediatric genetic testing for common disease risk.
Authors: Tercyak K.P. , Hensley Alford S. , Emmons K.M. , Lipkus I.M. , Wilfond B.S. , McBride C.M. .
Source: Pediatrics, 2011 May; 127(5), p. e1288-95.
EPub date: 2011-04-18.
PMID: 21502235
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