The role of religious and existential well-being in families with Lynch Syndrome: Prevention, family communication, and psychosocial adjustment

Abstract

This study explored the role of religious (RWB) and existential well-being (EWB) on psychosocial factors, support network characteristics, and screening practices in families with Lynch syndrome, also referred to as hereditary nonpolyposis colon cancer (HNPCC). Participants were individuals with Lynch syndrome associated cancers and their first-degree relatives at risk of inheriting an identified deleterious mutation. Analyses considered both family RWB and EWB norms and individual deviations from that norm. Analyses controlled for age, gender, cancer diagnosis, number of respondents, and network size. Higher family RWB was associated with increased depressive symptoms (p<.05) and avoidant cognitions (p<.05). Higher family EWB was related to decreased depression symptoms (p<.001). Higher family EWB was associated with fecal occult blood testing (p<.01), and family communication about genetic counselling and testing (p<.01). Analyses pointed to individual effects of EWB above and beyond family-level effects. Individuals with lower EWB than their family had lower perceived risk for colorectal cancer (p<.05), communicated disease risk information to less family members (p<.05), andwere less likely to undergo recent colonoscopies (p<.05). Participants with lower EWB than their family also had higher cancer worry (p<.01) and increased depressive symptoms (p<.001). Findings indicate the importance of assessing individuals within the context of their family network and being aware of family characteristics which may impact individual adjustment to disease risk. Interventions considering family-level factors may provide efficient pathways to improving psychosocial factors, screening practices, communication about disease risk and genetic testing, and cancer prevention.