“How do we rally around the one who was positive?” Familial uncertainty management in the context of men managing BRCA-related cancer risks

Rationale: Men with BRCA-related cancer risks face increased disease risk as well as the prospect of passing on their risk to children. Objective: This study investigates men's communicative appraisal and management of uncertainty related to BRCA-related cancer risks and decision-making. Methods: Guided by uncertainty management theory (UMT), a directed content analysis approach was utilized to analyze interviews with 25 men who either carry a pathogenic BRCA variant or have a 50% chance of carrying a variant but have not yet been tested. Results: Participants appraised their individual uncertainty as irrelevant or dangerous but appraised their familial uncertainty as dangerous. Men appraising their uncertainty as a danger exhibited more proactive information seeking healthcare behaviors—such as genetic testing and following recommended screenings—than men who appraised their uncertainty as irrelevant. Participants appraised familial uncertainty as a danger and were engaged in information management with family members, as well as encouraging family members to engage in proactive healthcare decision-making. Conclusions: Men with BRCA-related cancer risks lack understanding about their risks and how to manage them. Increased attention should be paid to the development of interventions tailored specifically to men. Further, interventions focusing on strategically developing proactive family communication behaviors would also be beneficial to men and their families.