The role of genetic counselling for colorectal cancer in improving emotional, cognitive, and behavioural outcomes

Abstract

Background: Genetic counselling is often recommended for individuals with a personal or familial history of colorectal cancer but the impact of this intervention has been less explored. The objective of this study was to assess the impact of genetic counselling on various outcomes: emotional (e.g., anxiety, depression), cognitive (e.g., knowledge, risk perception), behavioural (e.g., screening uptake). Methods: An extensive search was conducted in electronic databases (PubMed, PsycInfo and Cochrane) investigating the literature published until January 2017. We included studies which investigated the impact of genetic counselling for colorectal cancer; clearly defined genetic counselling; included patients diagnosed with colorectal cancer or family members at risk. Two authors independently assessed the quality of studies. Findings: Thirty-one studies met our inclusion criteria. Results show that genetic counselling improves cognitive outcomes such as knowledge and risk perception. Emotional distress (e.g., anxiety, depression) is usually higher immediately after the genetic test disclosure session but is decreasing at follow up assessments. In terms of screening adherence, genetic counselling had a positive impact for the mutation positive individuals, but mutation negative individuals usually failed to comply with the screening recommendations. Discussion: This systematic review includes all studies which investigated the impact of genetic counselling for colorectal cancer. Studies included in this systematic review showed that genetic counselling improves emotional, cognitive and behavioural outcomes in individuals affected or at risk for familial colorectal cancer.