Journal of Experimental & Clinical Cancer Research 2008, 27:75 http://www.jeccr.com/content/27/1/75 from 0 to 100%; 0 representing the lowest risk, 100 the highest and a blank space "do not know". Anxiety and Depression The Hospital Anxiety and Depression Scale (HADS) [17], Italian version and mean score [18], is used in literature to evaluate the psychological distress in a non-psychiatric setting. It is composed of two scales of 14 items, 7 regard- ing anxiety and 7 regarding depression. The two scores can be calculated separately with three cut-offs: normal (0–7), borderline (8–10) disturbance (above 11). By calculating the sum of the two scales, it is possible to identify the pres- ence of disturbance in adaptation(cut-off 13–18), or an episode of heavy depression (cut-off > 19). No psycholog- ical distress is evidenced if the sum of the two scores totals < 13. Family structure and functioning Family Adaptability and Cohesion Evaluation Scale (FACES III) of D.H. Olson [19], Italian version by Galim- berti C. and Farina M. [20], reliability within this sample α = 0,847, evaluates the perception of family functioning on the basis of adaptability and cohesion according to a Circumplex model developed by David Olson et.al. There are four levels of family cohesion (disengaged, separated, connected and enmeshed), and four levels of adaptability (rigid, structured, flexible and chaotic). This Circumplex model classifies the family into 16 spe- cific types, or more generally, according to a three-way division defined as " balanced", "mid-range" and "extreme". Moreover, this measure is used to obtain infor- mation about the true or ideal functioning of families The discrepancy between the true and ideal family indicates the measure of family dissatisfaction The test is made up of 40 multiple-choice items (20 for the actual family, 20 for the ideal). Motivation A questionnaire was composed of 22 true/false items to indicate the reasons behind the decision to choose not to pursue genetic counselling. The questionnaire was adapted from prior research to indicate limitations and benefits derived from the test [3] as well as to ascertain possible barriers to undergoing screening, as perceived by women [21]. Statistics Descriptive statistics were used to summarize the perti- nent information. Association between dichotomous or categorical variables was tested by the Pearson Chi-Square test (for the trend when necessary). Rank-order correla- tion was measured by the Spearman RHO coefficient. The SPSS (11.0) statistical program was used for analysis. Results Sample description The description of the sample is reported in table 1 (socio- demographic and medical characteristics) and in table 2 (psychological characteristics; *14 subjects do not know how to express their risk of breast and/or ovarian cancer and **15 subjects do not know how to express their risk of being carriers of the genetic BRCA1 e BRCA2 mutation genes). Socio-demographic and medical characteristics The sample was made up of 56 subjects, 2 men and 54 women. Eighteen were affected by breast or ovarian can- cer (1 male breast tumour). Thirty-eight were healthy but with a family history of cancer. The average age was 48.6 years and the average number of family members affected by cancer was 3.9. Most of the sample were Roman Catholic (92%), but only 50% claimed to be practicing, 46% had finished high school, 19% had a university degree and more than a third of the sample had a middle or elementary school level. Seventy percent were married and 73% had at least one child. An equal number of subjects were either unem- ployed or employed (52%v 48%). There are no significant differences between cancer affected women and healthy women regarding socio-demographic characteristics, risk perception and anxiety levels. Table 1: Socio-demographic and medical characteristics N = 56 subjects Age Number of relatives affected by cancer Mean 48,6 3,9 Frequency Range 27–70 0–13 % Status Number of children Single Married No children Up to two children More than two children Elementary and middle Higher Degree Workers Non workers Roman Catholic Other Practicing Non practicing Affected Not affected Education Work Religion Practicing Disease 17 39 15 29 12 19 26 11 27 29 52 4 28 28 18 38 30,4 69,6 26,8 51,8 21,4 33,9 46,4 19,6 48,2 51,8 92,9 7,1 50 50 32,1 67,9 Page 3 of 8 (page number not for citation purposes)