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J Mackay

Publications and source records attributed to J Mackay.

107 records · Page 6Linked to original sources

The psychological consequences of offering mutation searching in the family for those at risk of hereditary breast and ovarian cancer--a pilot study.

AIM: To describe the short and longer-term psychological consequences of waiting for the results of mutation searching (MS) amongst those at risk of hereditary breast and ovarian cancer (HBOC). DESIGN: A prospective study, with measures before the offer of a mutation search, and 1 week, 6 months and 12 months afterwards. SAMPLE: 21 unaffected women at risk of HBOC offered MS in an affected relative at one of two UK regional genetics centres. OUTCOME MEASURES: Standardized questionnaire measures of general anxiety, general distress, distress about cancer in the family and cancer-specific worries. RESULTS: Mutation searches were initiated in 15 of 21 families; two received results within 12 months. For the 13 still waiting for results, levels of anxiety and distress were within normal ranges at all time-points. They reported reduced worries about cancer 6 and 12 months post-search offer compared with earlier assessments, but experienced an increase in general anxiety 12 months since the search offer. These changes over time were not found in those not waiting for the results of a mutation search. CONCLUSION: The majority of women were without a result 12 months after being offered MS. Whilst these women were less worried about cancer in the 6 months after initiating the testing process, their anxiety levels increased 12 months since the offer of a mutation search. Seeing a specialist seems to reduce cancer worries. There may, however, be long-term psychological costs of offering tests that are unlikely to give results in a foreseeable future.

Adult↗

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Breast Neoplasms↗

Women and tobacco: international issues.

Most women live in the developing world, and of these, between 2% and 10% smoke cigarettes, although in some regions women more commonly chew tobacco. There can be no complacency about the lower level of tobacco use among women; it does not reflect health awareness, but rather social traditions and women's low economic resources. The number of women smokers will inevitably increase: the female population in developing countries will rise from the present 2.1 to 3.5 billion by 2025, women's spending power is increasing, the tobacco companies are targeting women, governments may be less aware of the harmfulness of smoking and are preoccupied with other health issues, and woman-specific health education and quitting programs are rare. Tobacco-related health problems have hitherto been masked by women's shorter life expectancy, but rural women who become sick from tobacco-related diseases have extremely limited access to health care. In addition, tobacco inflicts a particularly heavy economic burden on women in developing countries. Women's health organizations in Western countries have a special responsibility in addressing, reducing, and preventing further expansion of the global tobacco epidemic among women.

Adolescent↗

Genetic screening: risk factors for breast cancer.

The field of cancer genetics is rapidly changing. Demand for information on genetic testing is increasing and persistent patient pressure is likely to result in increased NHS resource allocation. Cancer genetics clinics must change from small ad hoc research clinics to large throughput, patient-centred specialist services run jointly by doctors and clinical nurse specialists expert in cancer genetics and cancer medicine. We describe the development of a regional breast cancer genetics service in East Anglia based on the three-tier cancer care model outlined in the Calman report.

Breast Neoplasms↗

The global tobacco epidemic. The next 25 years.

The Transnational Commercial Tobacco Companies are expanding their empires--denying the health evidence on the effects of smoking; advertising and promoting their products in every corner of the earth; obstructing government action; overpowering national monopolies; and selling more and more cigarettes. Their grip on the big markets in developing countries will become stronger as they move their agriculture and manufacturing processes out of the United States, and by 2025 there may be no tobacco grown in the United States.

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