Personal attributions for melanoma risk in melanoma-affected patients and family members.

Personal attributions for cancer risk involve factors that individuals believe contribute to their risk for developing cancer. Understanding personal risk attributions for melanoma may dictate gene-environment melanoma risk communication strategies. We examined attributions for melanoma risk in a population-based sample of melanoma survivors, first degree family members, and family members who are also parents (N = 939). We conducted qualitative examination of open-ended risk attributions and logistic regression examining predictors (demographics, family member type, perceived risk) of the attributions reported (ultraviolet radiation [UVR] exposure, heredity/genetics, phenotype, personal melanoma history, miscellaneous). We found a predominance of risk attributions to UVR and heredity/genetics (80 and 45% of the sample, respectively). Those reporting higher education levels were more likely to endorse attributions to heredity/genetics, as well as to phenotype, than those of lower education levels. First-degree relatives and parent family members were more likely to endorse heredity/genetic attributions than melanoma survivors; melanoma survivors were more likely to endorse personal history of melanoma attributions compared to first-degree relatives and parent family members. These findings inform the development of risk communication interventions for melanoma families.

Anticipating dissemination of cancer genomics in public health: a theoretical approach to psychosocial and behavioral challenges.

BACKGROUND: Given the recent sequencing of the human genome, genetic susceptibility information will probably be increasingly useful in the prevention and control of many common diseases, including cancer. PURPOSE: Although much is known about psychosocial factors related to the impact of cancer genetic testing among high-risk families in specialized clinic settings, much less is known about how genetic susceptibility information may contribute to the health and well-being of the general population. METHODS: We present a theoretical synthesis drawn from the health communication and health behavior change traditions to guide research examining psychosocial and behavioral challenges central to dissemination of cancer genomics in public health. RESULTS: These challenges include (a) anticipating individuals' reactions to receiving genetic information that is probabilistic and derived from multiple sources; (b) modeling the influence of public communication about genetics on the population; (c) confronting the need to disseminate cancer genomic information through public health channels; and (d) maximizing opportunities to achieve cancer risk reduction across individuals, families, and local environments. Throughout the article, we use melanoma genomics as an example of the issues requiring attention. CONCLUSIONS: We hope the model helps shape the psychosocial and behavioral research agenda concerning the impact of cancer genomics outside the high-risk clinic.