Evidence map›Paper›PMID 40596937›Full record

Observational studyBMC cancer2025

BRCA cascade counselling and testing in Italy: current position and future directions.

Silvia Costanzo, Lea Godino, Simona De Summa, Tommaso Maria Marvulli, Maurizio Genuardi, Maria Luisa Di Pietro, Emanuela Lucci Cordisco, Daniela Turchetti, Sara Miccoli, Giuseppe Deledda and 8 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Silvia CostanzoHeredo-Familiar Cancer Clinic, IRCCS - Istituto Tumori''Giovanni Paolo II'', Bari, Italy. s.costanzo@oncologico.bari.it.
Lea GodinoMedical Genetics Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
Simona De SummaMolecular Diagnostics and Pharmacogenetics Unit, IRCCS - Istituto Tumori''Giovanni Paolo II'', Bari, Italy.
Tommaso Maria MarvulliMolecular Diagnostics and Pharmacogenetics Unit, IRCCS - Istituto Tumori''Giovanni Paolo II'', Bari, Italy.
Maurizio GenuardiDepartment of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
Maria Luisa Di PietroDepartment of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
Emanuela Lucci CordiscoDepartment of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
Daniela TurchettiMedical Genetics Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
Sara MiccoliMedical Genetics Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
Giuseppe DeleddaClinical Psychology Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, PsyDVerona, Italy.
Giovanna FantoniClinical Psychology Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, PsyDVerona, Italy.
Valeria ViassoloMedical Genetics, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy.
Oronzo BrunettiS.S.D. C.O.R.O. Bed Management Presa in Carico, TDM, IRCCS Istituto Tumori''Giovanni Paolo II'', Bari, Italy.
Raffaele De LucaDepartment of Surgical Oncology, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
Maria DigennaroHeredo-Familiar Cancer Clinic, IRCCS - Istituto Tumori''Giovanni Paolo II'', Bari, Italy.
Francesca RomitoServizio Di Psiconcologia, IRCCS Istituto Tumori'Giovanni Paolo II', Bari, Italy.
Maria CampanellaETS- Italian National Advocacy On BRCA Carriers. Settimo Milanese-Milano, Settimo Milanese, Italy.
Margherita PatrunoHeredo-Familiar Cancer Clinic, IRCCS - Istituto Tumori''Giovanni Paolo II'', Bari, Italy.

Funding

Progetto 5x1000 - Ministero della Salute - Ricerca di potenziali marcatori predittivo/prognostici tissutali e circolanti in pazienti con adenocarcinoma del pancreas e delle vie biliari intra ed extraepatiche nei setting adiuvante e metastatico - CUP: F93C23000120001 - delib n.303/2023 - P.I. CUP: F93C23000120001 - delib n.303/2023
6 · The paper itself

Abstract

backgroundGenetic testing has led to a considerable enhancement in the ability to identify individuals at risk of Hereditary Breast and Ovarian Cancer syndrome related to BRCA1/2 pathogenic variants, thus necessitating personalised prevention programs. However, barriers related to intrafamilial communication, privacy regulations, and genetic information dissemination hinder preventive care, particularly in Italy, where legal constraints limit the disclosure of genetic risks to at-risk relatives. This study examines the relationship between BRCA1/2 carriers' communication challenges and three factors: cancer status, comprehension of genetic information, and the genetic counseling pathway accessed (Traditional Genetic Counseling, TGC vs. Mainstream Cancer Genetics, MCG).

methodsThis multicenter, prospective, observational study included 277 BRCA1/2 carriers (probands and relatives) aged 18-80 from various Italian centers. Participants completed a sociodemographic form, a self-administered survey, and psychological assessments (Impact of Event Scale, IES and Distress Thermometer, DT). Categorical variables were compared using Pearson's Chi-squared test or Fisher's exact test based on sample size and expected frequencies, whereas continuous variables were analyzed using the Wilcoxon rank-sum test because of non-normal data distribution.

resultsAmong the 277 carriers (115 probands, 162 relatives), 79.4% received TGC and 20.6% MCG. The cancer prevalence was higher in probands (83%) than in relatives (22%). The probands exhibited greater psychological distress (higher IES and DT scores), and cancer-affected relatives had higher distress levels than healthy relatives (p = 0.008). While no severe psychological distress or PTSD was found, distress was more associated with cancer diagnosis than genetic status. Genetic comprehension was significantly higher in relatives (p = 0.007) and in those who underwent TGC compared to MCG (p < 0.001). TGC carriers also better understood genetic risks and management strategies (p < 0.001).

conclusionsPsychological distress and genetic comprehension significantly influenced the communication. TGC enhances understanding more effectively than MCG, highlighting the need for tailored support for both carriers and healthcare professionals to improve cascade counseling and testing rates, and cancer prevention. As we look into the future, we need to critically approach MCG, and determine how to address carriers understanding and prevention needs and reincorporate a more comprehensive genetic risk assessment into the MCG model.

Indexed as

BRCA1 ProteinBRCA2 ProteinBreast NeoplasmsGenetic CounselingGenetic TestingHereditary Breast and Ovarian Cancer SyndromeAdolescentAdultAgedAged, 80 and overFemaleGenetic Predisposition to DiseaseHumansItalyMaleMiddle AgedBRCA1 ProteinBRCA1 protein, humanBRCA2 ProteinBRCA2 protein, humanBRCA1/2Cascade genetic counselling and testingCommunicationMainstream cancer geneticsPsychological distressTraditional genetic counselling

Identifiers

PMID40596937
PMCPMC12210843

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.