Impact of Lung Cancer Diagnosis on Relatives' Understanding of Genetic Risk and Receptivity to Quit Smoking
Condition: Lung Cancer
MeSH terms: Lung Neoplasms
Study type: Observational

Summary: 
      This study will explore beliefs and knowledge about genetics and smoking among smokers who
      have a first or second degree relative with advanced lung cancer, and whether their
      understanding of genetic risk influences their desire to quit smoking.

      Healthy adult smokers between 18 and 55 years of age who are first or second degree relatives
      (e.g., siblings, children, grandchildren, nieces, nephews, grandnieces or grandnephews) of a
      patient with advanced lung cancer who is receiving care at the Moffitt Cancer Center and
      Research Institute in Tampa, Fla. and the GUMC/LCCC, may be eligible for this study.
      Participants must be able to complete computer online surveys.

      Participants log on to a password-protected website to complete online educational sessions
      and surveys. The educational sessions include information on: 1) the role of smoking and
      genetics in the development of lung cancer; 2) glutathione S transferase (GSTM1), an enzyme
      made by the GSTM1 gene that "cleans up" toxins such as cigarette smoke and that may play a
      role in preventing lung cancer from developing; 3) pros and cons of being tested for GSTM1;
      and 5) a series of questions and answers about genetic testing. Participants are offered free
      genetic testing for GSTM1, and those who wish to be tested are sent materials to collect a
      sample from inside the cheek using a mouth rinse and return it to a laboratory at Duke
      University Medical Center. They later receive their results online.

      Participants also complete online surveys that ask about their risk perceptions, beliefs and
      attitudes related to lung cancer, emotional responses to their relative's diagnosis, smoking
      history and motivation to quit, reactions to information about smoking and genetic risk, and
      interest in receiving smoking cessation services. They are asked to review depictions and
      descriptions of smoking cessation materials offered through a quit smoking program at Duke
      University Medical Center and to evaluate the extent to which the various materials might be
      helpful. They are offered additional information among categories they can choose from.

      Participants are surveyed again by telephone 6 months after completing the online surveys.
    

Detailed description: 
      The overarching objective of this observational prospective "Genetic Risk & Lung Cancer
      Study" is to evaluate the impact of a loved one's lung cancer diagnosis on relative's seeking
      and processing of information related to risks of smoking, genetic susceptibility, and their
      receptivity to smoking cessation services. We plan to recruit 150 relatives of lung cancer
      patients who are receiving care at H. Lee Moffitt Cancer Center and Research Institute in
      Tampa, Florida and the Lombardi Comprehensive Cancer Center at the Georgetown University
      Medical Center (GUMC/LCCC). First- or second-degree blood relatives who are current smokers
      between the ages of 18 to 55 will be eligible for the study. Because these relatives will be
      living throughout the United Sates, a web-based research protocol will be employed. A nurse
      recruiter will approach patients at Moffitt and assess their willingness to do a telephone
      survey The overarching objective of this observational prospective "Genetic Risk & Lung
      Cancer Study" is to evaluate the impact of a loved one's lung cancer diagnosis on relative's
      seeking and processing of information related to risk of smoking, genetic susceptibility, and
      their receptivity to smoking cessation services. We plan to recruit 150 relatives of lung
      cancer patients who are receiving care at H. Lee Moffitt Cancer Center and Research Institute
      in Tampa, Florida. First-or second-degree relatives who are current smokers between the ages
      18 to 55 will be eligible for the study. Because these relatives will be living throughout
      the United States, a web-based research protocol wil be employed. A nurse recruiter will
      approach patients at Moffitt and assess their willingness to do a telephone survey to
      enumerate their relatives who smoke and be asked to give permission to contact none, some or
      all of these relatives. These survey contacts with patients and contacts with relatives for
      screening and recruitment will be conducted in partnership with an ongoing recruitment
      activities for a five-year, NCI-funded randomized controlled intervention trial (RCT) at Duke
      University Medical Center (Quit Smoking Program for Lung Cancer Patient's Families or "Family
      Ties", Duke IRB# 4620, Bastian, PI). Relatives who agree to participate will be asked to log
      on to a password protected website and view two online educational sessions and complete
      three online surveys. As part of the educational session, participants will be offered free
      geneticsusceptibility testing for glutathione S transferase (GSTM1). Participants who accept
      testing will receive their result online. Participants who decline testing will be retained
      in the the study and offered all the same smoking cessation services provided to those who
      accept testing. Participants will be sent instructions to collect their own buccal samples
      and postage-paid mailing envelopes to return the sample to a CLIA-approved laboratory at
      Duke. Survey assessments will include questions about risk perceptions, beliefs and attitudes
      related to lung cancer, emotional responses to the patient's diagnosis, smoking history,
      motivation to quit, reactions to information about smoking and genetic risk, interest in
      genetic testing, comprehension of susceptibility feedback, and interest in receiving smoking
      cessation services. The primary outcome variable will be seeking of free quit smoking
      services. Participating relatives will be surveyed by telephone via the Duke RCT
      infrastructure 6-months after completing the online protocol.
    

Keywords: Smoking; Smoking Cessation; GSTM1; Glutathione S. Transferase; Lung Cancer; Smokers; Genetic Risk Communication