Psychosocial interventions in the care of individuals with hereditary cancer risk: A scoping review.

Abstract

e22660 Background: Individuals with hereditary cancer predisposition syndromes experience significant psychological distress throughout the genetic counseling pathway. However, the integration of structured psychosocial care into genetic services remains unclear. Methods: This review mapped psychosocial interventions integrated into hereditary cancer genetic counseling process using PRISMA-ScR, searching Embase, PubMed, Cochrane, Scopus, CINAHL and SciELO. Inclusion criteria encompassed studies reporting psychosocial interventions delivered as part of genetic counseling/testing process that target patients with possible or confirmed hereditary cancer predisposition syndromes. From 621 publications identified, 8 met inclusion criteria after full-text review. Interventions targeted distress, decision-making, family communication, and health behaviors. Most interventions were executed by physicians, with limited mental health specialist involvement. Results: Psychosocial interventions were associated with reductions in depression, anxiety, and distress, better understanding of genetic risk, improved genetic testing uptake and counseling acceptance, and healthier lifestyle behaviors, although follow-up rarely extended beyond 12 months and outcome measures varied. Reporting of intervention components, training requirements, and procedures was often incomplete, limiting reproducibility and implementation in routine practice. Conclusions: Findings highlight the need for clearly described, psychologist-led or co-led protocols, integrated outcome metrics and longer follow-up to support scalable, evidence-based psychosocial care in hereditary cancer genetic services. Study characteristics. Syndrome Intervention Duration Professionals Key outcomes 1 HBOC Tailored phone counseling (CBT) 12 months Not reported Higher Cancer Genetic Risk Assessment uptake 2 BRCA1/2 Psychosocial telephone counseling + workbooks 6–12 months Mental health counselors, oncologists Reduced depression and testing distress; lower clinically significant anxiety at 6 months 3 HBOC Web-based “Family Gene Toolkit” Cross-sectional Physicians High satisfaction; 78% would have preferred access at time of own testing 4 HBOC Spanish video + navigation 3 months Nurse + other staff 72% attended counseling; 70% completed testing 5 BRCA1/2 Telephone vs in-person counseling + mailed visual aids (CBT) 3 months Physicians Noninferior for knowledge, distress, satisfaction; reduced cost per patient 6 BRCA1/2 One-day psychoeducational retreat 6 months Physicians 61% increased screening or prophylactic surgery; 50% improved exercise or diet 7 HBOC Problem-solving training (CBT) 6–9 months Physicians Greater reduction in depressive symptoms than client-centered counseling 8 HBOC Group therapy 6 months Psychiatrist Reduced depression, anxiety, avoidance; improved grief processing