Characterizing biased cancer-related cognitive processing: relationships with BRCA1/2 genetic mutation status, personal cancer history, age, and prophylactic surgery.

TitleCharacterizing biased cancer-related cognitive processing: relationships with BRCA1/2 genetic mutation status, personal cancer history, age, and prophylactic surgery.
Publication TypeJournal Article
Year of Publication2014
AuthorsCarpenter KM, Eisenberg S, Weltfreid S, Low CA, Beran T, Stanton AL
JournalHealth Psychol
Volume33
Issue9
Pagination1003-11
Date Published2014 Sep
ISSN1930-7810
KeywordsAdult, Age Distribution, Aged, Attitude to Health, Breast Neoplasms, Cognition, Decision Making, Female, Forecasting, Genes, BRCA1, Genes, BRCA2, Genetic Predisposition to Disease, Genetic Testing, Humans, Linear Models, Logistic Models, Los Angeles, Mastectomy, Middle Aged, Mutation, Ovarian Neoplasms, Ovariectomy, Reaction Time, Risk Assessment, Stroop Test
Abstract

OBJECTIVE: This study evaluated associations of cancer-related cognitive processing with BRCA1/2 mutation carrier status, personal cancer history, age, and election of prophylactic surgery in women at high risk for breast cancer.

METHOD: In a 2 (BRCA1/2 mutation carrier status) × 2 (personal cancer history) matched-control design, with age as an additional predictor, participants (N = 115) completed a computerized cancer Stroop task. Dependent variables were response latency to cancer-related stimuli (reaction time [RT]) and cancer-related cognitive interference (cancer RT minus neutral RT). RT and interference were tested as predictors of prophylactic surgery in the subsequent four years.

RESULTS: RT for cancer-related words was significantly slower than other word groups, indicating biased processing specific to cancer-related stimuli. Participants with a cancer history evidenced longer RT to cancer-related words than those without a history; moreover, a significant Cancer History × Age interaction indicated that, among participants with a cancer history, the typical advantage associated with younger age on Stroop tasks was absent. BRCA mutation carriers demonstrated more cancer-related cognitive interference than noncarriers. Again, the typical Stroop age advantage was absent among carriers. Exploratory analyses indicated that BRCA+ status and greater cognitive interference predicted greater likelihood of undergoing prophylactic surgery. Post hoc tests suggest that cancer-related distress does not account for these relationships.

CONCLUSIONS: In the genetic testing context, younger women with a personal cancer history or who are BRCA1/2 mutation carriers might be particularly vulnerable to biases in cancer-related cognitive processing. Biased processing was associated marginally with greater likelihood of prophylactic surgery.

DOI10.1037/a0032737
Alternate JournalHealth Psychol
PubMed ID23772886
Grant ListP30 CA16042 / CA / NCI NIH HHS / United States
R25 CA087949 / CA / NCI NIH HHS / United States