NIH Clinical Research Studies

Protocol Number: 95-HG-0165

Active Accrual, Protocols Recruiting New Patients

Title:
Outcomes of Education and Counseling for HNPCC Testing
Number:
95-HG-0165
Summary:
This study will explore the best way to teach and counsel people who may have a genetic mutation (change in a gene) responsible for a hereditary form of colon cancer. It will examine how a person's beliefs, values and family experiences affect their decision to be tested or not for changes in the two most common HNPCC (hereditary non-polyposis colon cancer) genes. HNPCC changes result in uncorrected DNA "replication errors." These are mistakes that occur when DNA-the genetic material in the cell nucleus-copies itself during cell division. These mistakes are common and normally are corrected by the HNPCC gene. If there is a change in the HNPCC gene, however, these errors may go undetected and accumulate. Their accumulation is thought to play a role in the development of this form of hereditary colon cancer.

Individuals 18 years of age and older with a family history of colon cancer, diagnosis of colon cancer at an early age (by 40 years old), or colon tumors or polyps that have replication errors may be eligible for this study. Closely related (first degree) adult family members may also participate, if a relative with colon cancer is found to have a mutation. The study will involve a minimum of one visit to NIH and a maximum of two visits to NIH in addition to two telephone interviews.

Visit 1 - Participants fill out a questionnaire assessing their knowledge, risk perception and personality traits, and receive information about HNPCC through an education and counseling session focusing on the potential benefits and risks of testing. They are then offered the option of HNPCC testing. Those who want to be tested provide a small blood sample (2 to 3 tablespoons) for genetic analysis. Those who choose not to be tested do not participate in any further visits but are contacted by telephone at a later time (see Telephone Interviews below). Any participant may change his or her mind at any time during the study regarding whether or not they want to be tested. Once the blood sample is collected, the individual may still decide not to receive the test results.

Visit 2 -For those choosing to undergo genetic testing. Test results are reviewed and discussed at this time with a genetic counselor, oncology (cancer) nurse and Medical Oncologist. (This visit takes place between 2-4 months after the blood sample collection.)

Telephone Interview #1- This interview takes place 6 months after the participant's decision not to be tested or the receipt of test results for those choosing testing. Participants will be interviewed by telephone. The interview collects information regarding mood, attitude, self-esteem, family interactions, cancer screening practices, and other factors.

Telephone Interview #2 - About a year after the test results are received (or a similar time frame for those who chose not to be tested), participants are once again surveyed by telephone. At this point, participation in the research is considered over.

Sponsoring Institute:
National Human Genome Research Institute (NHGRI)
Recruitment Detail
Type: Participants currently recruited/enrolled
Gender: Male & Female
Referral Letter Required: No
Population Exclusion(s): Children

Eligibility Criteria:
INCLUSION CRITERIA:

Patients 18 years of age or older.

1. Subjects presenting with a family history consistent with the Amsterdam criteria for HNPCC. 1) At least two relatives with histologically verified colorectal cancer; one of them should be a first degree relative of the other two. 2) At least two successive generations should be affected, and 3) In one of the relatives colorectal cancer should be diagnosed under 50 years of age, or;

2. Subjects diagnosed with colorectal cancer under 41 years of age (MSI status considered when tumor/polyp sample available) or;

3. Subjects with HNPCC associated cancer/polyps under the age of 41 which demonstrates a positive MSI phenotype, or;

4. Subjects with multiple primary HNPCC associated cancers regardless of family history, or;

5. Subjects with colorectal or other HNPCC associated tumor/polyp demonstrating a positive MSI phenotype and at least one second degree (or closer) and one third degree (or closer) relative with a HNPCC associated cancer; one of the affected family members (proband included) must have either right sided colon cancer, multiple primary HNPCC associated cancers or had the diagnosis of cancer prior to age 51 years, or;

6. Subjects who have a family member with a documented mutation in one of the HNPCC genes.

Special Instructions:
This protocol offers gene testing for HNPCC, one form of hereditary colon cancer, however, we are equally interested in individuals who may NOT choose testing.

Participation includes 2 (maximum) trips to NIH (expenses paid) and 2 telephone questionnaires.

Keywords:
Colon Cancer
Family History
High Risk
Behavioral and Attitudinal Changes
Family Responses
Recruitment Keyword(s):
Endometrial Cancer
Ovarian Cancer
Stomach Cancer
Colorectal Cancer
Condition(s):
Colonic Neoplasm
Colonic Polyps
Hereditary Neoplastic Syndrome
Investigational Drug(s):
None
Investigational Device(s):
None
Intervention(s):
None
Supporting Site:
National Human Genome Research Institute

Contact(s):
Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citation(s):
Interest in genetic testing for colon cancer susceptibility: cognitive and emotional correlates

Psychological issues in genetic testing for breast cancer susceptibility

Identification of an HNPCC family

Active Accrual, Protocols Recruiting New Patients

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