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“I have always believed I was at high risk…” The role of expectation in emotional responses to the receipt of an average, moderate or high cancer genetic risk assessment result: a thematic analysis of free-text questionnaire comments

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Abstract

It is well-recognised that receipt of cancer genetic risk information can evoke a mix of both positive and negative emotional responses. Objective risk itself is not necessarily predictive of emotional response to receipt of risk information and the Cue Adaptive Reasoning Account (CARA; Renner, 2004) suggests that that the degree to which level of risk is consistent with expectations may influence emotional responses. This paper reports a thematic analysis of the free-text data structured around responses to the three risk labels: average, moderate or high. Data is reported from both 123 women and 15 men, including those with a past or current cancer diagnosis. Reactions to risk information appear to be dependent upon participants’ pre-conceived expectations about their level of cancer risk. Many average risk respondents questioned the accuracy of their result, whereas high risk information was often expected. Findings are discussed in relation to the CARA model and clinical implications.

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Acknowledgments

The CARIAD Trial was funded by the Wales Office for Research & Development (WORD). All study procedures were approved by the Multi-centre Research Ethics Committee for Wales. We thank all the patients who took part in this study through the Cancer Genetics Service for Wales.

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Authors and Affiliations

  1. Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, Wales, UK

    J. Hilgart & K. Brain

  2. School of Psychology & Counselling, Swansea Metropolitan University, Swansea, Wales, UK

    C. Phelps

  3. Nursing, Health and Social Care Research Centre, School of Nursing and Midwifery Studies, Cardiff University, Cardiff, Wales, UK

    P. Bennett

  4. SEWTU, School of Medicine, Cardiff University, Cardiff, Wales, UK

    K. Hood

  5. Cancer Genetics Service for Wales, Institute of Medical Genetics, Cardiff and Vale University LHB, Cardiff, UK

    A. Murray

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  1. J. Hilgart
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  2. C. Phelps
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  3. P. Bennett
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  4. K. Hood
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  5. K. Brain
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  6. A. Murray
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Correspondence to J. Hilgart.

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Hilgart, J., Phelps, C., Bennett, P. et al. “I have always believed I was at high risk…” The role of expectation in emotional responses to the receipt of an average, moderate or high cancer genetic risk assessment result: a thematic analysis of free-text questionnaire comments. Familial Cancer 9, 469–477 (2010). https://doi.org/10.1007/s10689-010-9324-y

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