22P - Impact of an online Asian genetic risk calculator on risk perception: Cancer-related distress and uptake of genetic counselling among Malaysian breast cancer patients (The ARiCa Study)

Background

To date, empirical methods using age, type of cancer and presence of family history of cancers are used clinically to identify individuals who may benefit from genetic counselling (GC) and testing, but because these guidelines use a threshold, they provide a standard recommendation regardless of whether women have a low (e.g. 4%) or high (e.g. 40%) likelihood of being BRCA carriers. We developed the Asian Genetic Risk Calculator (ARiCa), an Asian-specific personalised genetic risk assessment tool, to determine the probability of a breast cancer patient carrying a germline BRCA1/2 pathogenic or likely pathogenic variant. The ARiCa Study was established to evaluate the impact of personalised risk score on risk perception and cancer-related distress, and uptake of GC among breast cancer patients.

Methods

The ARiCa Study is a prospective observational multicentre two-arm study where 256 incident and prevalent breast cancer patients in breast surgical clinics who have previously not received GC will be randomised to receive genetic risk assessment based on current clinical criteria (controls) or ARiCa personalised risk score. The patients’ risk perception, distress level and GC uptake were determined via researcher-administered questionnaires six weeks after risk assessment.

Results

Interim analysis of 110 patients showed that compared to controls, a greater proportion of patients receiving ARiCa scores felt that the genetic risk information provided was easy to understand (92% vs 88%, p= 0.523) and influenced their decision on GC uptake (86% vs 78%, p=0.299). More participants also proceeded with GC (47% vs 39%, p=0.526) but none of the results were statistically significant. No significant distress after receiving genetic risk assessment was reported. Patients provided with personalized scores found that the visual (96%) and numerical (90%) forms of risk presentation were more helpful than the qualitative (84%) forms.

Conclusions

These interim results showed that personalized genetic risk assessment using visual and numerical forms of risk presentation is acceptable and may be a useful tool in facilitating the uptake of GC among breast cancer patients.

Clinical trial identification

NMRR ID-21-02298-7JY (IIR).

Editorial acknowledgement

Legal entity responsible for the study

Cancer Research Malaysia.

Funding

AstraZeneca.

Disclosure

C.H. Yip: Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Invited Speaker: AstraZeneca. A.F. Abdul Aziz: Financial Interests, Personal, Invited Speaker: Roche; Non-Financial Interests, Personal, Member of Board of Directors, a non-governmental non-profit organsiations: National Cancer Society Malaysia; Non-Financial Interests, Personal, Other, Fellow: College of Surgeons, Academy of Medicine Malaysia; Non-Financial Interests, Personal, Member: Malaysian Oncological Society. W.K. Ho, B.H. Ang: Other, Institutional, Other, Pending ARiCa trademarking: Cancer Research Malaysia. S.Y. Yoon: Financial Interests, Personal, Invited Speaker, Honorarium as invited speaker: AstraZeneca. S. Teo: Financial Interests, Institutional, Research Grant, For ARiCa Study: AstraZeneca; Other, Institutional, Other, Pending ARiCa trademarking: Cancer Research Malaysia. All other authors have declared no conflicts of interest.