Development and validation of an epidemiological risk score for early detection of pancreatic cancer in high-risk individuals within the IMAGene project Lois Riobó-Mayo, Lluis Salvador, Alex Teulé, Elisabet Guinó, Laura Layos, et al. International Journal of Epidemiology, 2026 Background Early detection is critical in pancreatic ductal adenocarcinoma (PDAC)—one of the most lethal malignancies due to its typically late diagnosis. Methods In this study, we aimed to validate an epidemiological risk score (ERS) designed to identify individuals at increased risk of developing PDAC prior to the use of imaging or other diagnostic procedures. The ERS was constructed through a meta-analysis of 24 well-established epidemiological risk factors. We applied this score to a prospective cohort of 178 high-risk individuals with a family history of PDAC within the IMAGene project (ClinicalTrials.gov registration code: NCT06334458). To evaluate the predictive value of the ERS, all participants underwent whole-body or abdominal magnetic resonance imaging (MRI) and the findings were classified according to the Oncologically Relevant Findings Reporting and Data System criteria to identify and categorize lesions based on their malignant potential. External validation was conducted by using a subset of the UK Biobank (UKB) cohort (≈300 000 individuals), among whom 1648 were diagnosed with PDAC. Results Higher ERS values were associated with the presence of potentially malignant lesions on MRI. Both pancreatic and extra-pancreatic malignant lesions were more frequent among individuals with higher ERS scores (P = .01 and P = .02 respectively) compared with controls. External validation in PDAC cases within the UKB cohort confirmed these associations. Conclusion Our findings support the integration of the ERS as a feasible, low-cost tool for PDAC risk stratification, with the potential to facilitate earlier detection and improve clinical outcomes.
Sailing toward healing. A combined group intervention to improve well-being in breast cancer survivors: a brief report study Valeria Sebri, Giulia Ongaro, Alice Viola Giudice, Ketti Mazzocco, Gabriella Pravettoni European Journal of Cancer Prevention, 2026 Breast cancer survivors often face persistent physical and emotional challenges. Evidence suggests that physical exercise and group psychological interventions can improve well-being and illness adjustment. This pilot study examined the effectiveness of a combined intervention delivered in a natural environment. Sixty female breast cancer survivors (M age = 51.0; SD = 5.5) participated in a 1-week program consisting of daily sailing lessons and group psychological sessions designed to address cancer-related issues. Assessments were conducted 1 week before and 1 week after the intervention using the Functional Assessment of Cancer Therapy–Breast (FACT-B) to assess quality of life and the State-Trait Anxiety Inventory. Linear mixed-effects models tested changes over time in quality of life and anxiety and whether previous psychotherapy or physical activity influenced these outcomes. FACT-B total scores significantly improved over time ( P = 0.004), with gains in physical well-being ( P < 0.001), emotional well-being ( P < 0.001), and breast cancer–specific concerns ( P = 0.018). No changes over time were observed in social or functional well-being. Anxiety levels remained moderate and stable ( P = 0.250). Previous psychotherapy and physical activity did not significantly influence changes in quality of life or anxiety. A short-term group intervention combining sailing lessons and psychological sessions in a natural environment may enhance quality of life in breast cancer survivors, particularly in physical and emotional domains. These findings suggest that integrative approaches addressing both physical and psychological health are feasible and warrant further investigation in larger controlled studies.
Can Family Motivation Enhance Men’s Uptake of Cascade Screening for Familial BRCA1/2 Mutations? Giulia Ongaro, Serena Petrocchi, Mariarosaria Calvello, Bernardo Bonanni, Irene Feroce, et al. American Journal of Men S Health, 2025 Pathogenic variants in the BRCA1 and BRCA2 genes increase the relative and absolute risks of developing breast, ovarian, prostate, and pancreatic cancer. Clinical guidelines recommend cascade screening (CS) to enhance the identification of at-risk relatives. Despite the benefits of CS in facilitating access to appropriate cancer screening and risk-reduction strategies, CS uptake remains relatively low, particularly among at-risk men. Men’s decisions regarding CS appear to be driven more by familial rather than individual disease risk, framing the decision as a family duty. Little is known about the motivational factors that could encourage men’s participation in CS. This randomized controlled trial aimed to evaluate the effectiveness of two first-person, gain-framed messages in promoting CS intention among at-risk men: one featuring a self-referred narrative (SM) and the other a family-referred narrative (FM). A total of 110 male first-degree relatives of female BRCA1/2 carriers were randomized into two groups. T -tests revealed no significant difference between groups in perceived message quality. Additionally, after controlling for age, the type of message received did not significantly influence participants’ levels of intention to undergo CS. These findings highlight the need for further exploration of the complex motivational factors influencing at-risk men’s adherence to CS. Future research should consider alternative health communication strategies tailored to different motivational drivers.
A Multi-Level Analysis of Barriers and Promoting Factors to Cascade Screening Uptake Among Male Relatives of BRCA1/2 Carriers: A Qualitative Study G. Ongaro, J. G. Hamilton, V. Groner, J. L. Hay, M. Calvello, et al. Psycho Oncology, 2025 BackgroundPathogenic variants in the BRCA1/2 genes significantly elevate risks of breast, ovarian, prostate, and pancreatic cancer. Clinical guidelines recommend cascade screening (CS) to identify at‐risk family members and advance genetically targeted disease prevention. However, despite the benefits of CS, testing uptake remains suboptimal, particularly among male first‐degree relatives (FDRs) of female BRCA1/2 carriers.AimsLittle is known about factors that hinder or enhance the implementation of CS in at‐risk men in BRCA‐positive families. This qualitative study explored multifaceted barriers and promoting factors influencing CS in 11 untested male FDRs.MethodsParticipants engaged in semi‐structured interviews exploring their experiences and perspectives regarding CS uptake. Thematic analysis, guided by the Health Action Process Approach, revealed a complex interplay of barriers and promoting factors at individual, interpersonal, provider, and environmental levels.ResultsKey barriers included limited awareness and communication, inaccurate knowledge regarding genetic testing, logistical constraints, and concerns regarding potential psychological outcomes. Potential promoting factors encompassed factors such as men's stage of life, actionability of genetic testing results, perceived benefit of prevention, familial cohesion, and provider direct recommendations.ConclusionsThese findings contribute to a deeper understanding of the factors shaping CS uptake within BRCA‐positive families and hold implications for targeted interventions to enhance CS uptake and improve the management of hereditary cancer syndromes. Gender‐specific education and public awareness campaigns are crucial, highlighting male cancer risk and surveillance strategies. Exploring alternative delivery methods, such as direct provider engagement with at‐risk males, can address challenges of low CS uptake, moving beyond traditional patient‐mediated approaches.
Decision-making process about prenatal genetic screening: how deeply do moms-to-be want to know from Non-Invasive Prenatal Testing? Serena Oliveri, Giulia Ongaro, Ilaria Cutica, Giulia Menicucci, Debora Belperio, et al. BMC Pregnancy and Childbirth, 2023 Background Prenatal information may be obtained through invasive diagnostic procedures and non-invasive screening procedures. Several psychological factors are involved in the decision to undergo a non-invasive prenatal testing (NIPT) but little is known about the decision-making strategies involved in choosing a specific level of in-depth NIPT, considering the increased availability and complexity of NIPT options. The main aim of this work is to assess the impact of psychological factors (anxiety about pregnancy, perception of risk in pregnancy, intolerance to uncertainty), and COVID-19 pandemic on the type of NIPT chosen, in terms of the number of conditions that are tested. Methods A self-administered survey evaluated the decision-making process about NIPT. The final sample comprised 191 women (Mage = 35.53; SD = 4.79) who underwent a NIPT from one private Italian genetic company. Based on the test date, the sample of women was divided between “NIPT before COVID-19” and “NIPT during COVID-19”. Results Almost all of the participants reported being aware of the existence of different types of NIPT and more than half reported having been informed by their gynecologist. Results showed no significant association between the period in which women underwent NIPT (before COVID-19 or during COVID-19) and the preferences for more expanded screening panel. Furthermore, regarding psychological variables, results showed a significant difference between perceived risk for the fetus based on the NIPT type groups, revealing that pregnant women who underwent the more expanded panel had a significantly higher level of perceived risk for the fetus than that reported by pregnant women who underwent the basic one. There was no statistically significant difference between the other psychological variables and NIPT type. Conclusions Our findings indicate the paramount role of gynecologist and other health care providers, such as geneticists and psychologists, is to support decision-making process in NIPT, in order to overcome people’s deficits in genetic knowledge, promote awareness about their preferences, and control anxiety related to the unborn child. Decision-support strategies are critical during the onset of prenatal care, according to the advances in prenatal genomics and to parent’s needs.
Caregiving and Shared Decision Making in Breast and Prostate Cancer Patients: A Systematic Review Clizia Cincidda, Silvia Francesca Maria Pizzoli, Giulia Ongaro, Serena Oliveri, Gabriella Pravettoni Current Oncology, 2023 Background: A cancer diagnosis can impact patients’ and caregivers’ lives, posing different challenging situations. In particular, breast cancer and prostate cancer are two types of cancer involving families and especially spouses in challenges linked with the diagnosis and treatment process. Caregivers are usually involved in the treatment decision-making (TDM) process concerning patients’ clinical pathway, cancer treatment, and ongoing therapies. To date, no contributions provide an exhaustive overview of the role of caregivers in cancer care and their involvement in the TDM process related to the therapies. Methods: We performed a systematic review of caregiver and patients experiences and perceptions of caregiver involvement in cancer TDM. Articles were searched on Public/Publisher MEDLINE (PubMed), Excerpta Medica Database (Embase), Medical Literature Analysis and Retrieval System Online (Medline), and American Psychological Association APA PsycINFO. Results: 17 studies were included, 10 on prostate cancer and 7 on breast cancer. According to the reviewed studies, patients and caregivers experienced the cancer diagnosis with a sense of unity. Most patients preferred to have an active or collaborative role with caregivers in TDM, feeling it was important to consult or share the decision made with their caregivers. Caregivers preferred to collaborate with patients or let patients decide by themselves after considering their opinions. Caregiver involvement could have a positive influence on the patient’s medical decisions, even if cancer diagnosis and treatments overwhelmed patients and caregivers. Conclusions: These findings highlight the importance of using a perspective that focuses on the relationship between a patient and caregivers when they receive a cancer diagnosis and have to make a treatment decision. Targeting caregiver–patient dyads, rather than individuals, is important since a supported relationship could have a protective effect on psychological distress, quality of life (QOL), and relationship satisfaction. Moreover, dyads may benefit from interventions that focus on the needs of both the patient and caregiver.
A randomized controlled trial comparing self-referred message to family-referred message promoting men’s adherence to evidence-based guidelines on BRCA1/2 germline genetic testing: A registered study protocol S. Petrocchi, G. Ongaro, M. Calvello, I. Feroce, B. Bonanni, et al. Plos One, 2022 Background This is a registered study protocol on a randomized controlled trial (RCT) testing an intervention aimed to improve men’s adherence to evidence-based guidelines on BRCA1/2 germline genetic testing. BRCA1- and BRCA2-associated Hereditary Breast and Ovarian Cancer Syndrome (HBOC) increases the relative and absolute risk of developing breast and ovarian cancer and, to a lesser extent, prostate and pancreatic cancer. Men face BRCA-related cancer risks as women do, although with a different magnitude, and they may also transmit the mutations to their children. Notwithstanding, men are under-tested compared to women and the communication is not tailored on their needs. The present RCT applies principles of the Health Action Process Approach (HAPA) in testing the psychological determinants of the men’s adherence to evidence based guidelines on BRCA1/2 germline genetic and testing the efficacy of two messages. Methods A total of 264 participants will be involved, among the men’s relatives of women with verified germline mutations. The study entails a pre- post- evaluation with randomization of the participants in two conditions corresponding to the two messages. Discussion The expected results provide answers related to the impact of action self-efficacy, outcome expectancy (personal or familiar), risk perception, health risk aversion, intolerance of uncertainty, perceived barriers, and coping self-efficacy on informed decision-making. Data gathered from this study may inform health care providers, policy makers, and public health managers about the communication strategy for men and about the psychological variables influencing decision-making. Trail registration Name of the Registry: Clinical Trials. Trial registration number: NCT04683068. Date of registration: 16/12/2020. URL of trial registry record: https://www.clinicaltrials.gov/.
Psychological Determinants of Men’s Adherence to Cascade Screening for BRCA1/2 Giulia Ongaro, Serena Petrocchi, Mariarosaria Calvello, Bernardo Bonanni, Irene Feroce, et al. Current Oncology, 2022 BRCA1/2 germline mutations predispose carriers to an increased risk of breast, ovarian, prostate, pancreatic, and skin cancer. Men and women are equally likely to pass on or inherit the pathogenic variant. However, there is evidence that male relatives are less involved in cascade screening than female ones. At the same time, little attention has been given to the research on psychological determinants of men’s adherence to cascade screening in BRCA1/2-positive families. Applying some principles of the Health Action Process Approach model, the present research tested a model of relationships on the adherence to BRCA1/2 cascade testing guidelines. The sample comprised 115 men’s first-degree relatives of women with verified germline mutations (Mage = 41.93; SD = 17.27). A pre–post test design was applied. Significant associations emerged between the intention to uptake BRCA1/2 genetic testing and age, parental status, breast cancer risk perception, self-referred outcome expectancies, perceived benefit, coping self-efficacy, and planning. Higher perceived benefit predicted increases in intention, and higher intention and coping self-efficacy predicted increases in planning. Intention was a positive total mediator of the relationship between benefit and planning. On a theoretical level, our findings partially supported the Health Action Process Approach as a valuable model based on which interventions could be developed in the context of cascade screening for BRCA1/2 genetic testing. Those results supported the importance of integrated genetic counselling sessions with a strict collaboration between geneticists and psychologists together with interventions planned to increase men’s self-monitoring ability to support their self-efficacy.
