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The completion rates of different steps of the testing and counselling procedure may be overestimated.
All the families included were recruited through a clinicogenetic counselling procedure and were considered BRCA1 and BRCA2 negative [ 15, 16].
The pedigrees made as a part of the genetic counselling procedure were studied for fulfilment of Amsterdam II criteria and Bethesda guidelines (Rodriguez-Bigas et al, 1997; Umar et al, 2004).
New counselees may be helped by receiving more information on the counselling procedure prior to their visit, and may be advised to prepare the visit more thoroughly so as to help them verbalise more their queries during the visit.
Of these 105 couples, 58 withdrew or were not accepted after the medical intake for various reasons (summarized in Table I), leaving 47 couples for the second appointment for the psychological intake and counselling procedure.
To achieve uniform risk communication in the genetic counselling sessions, several precautions have been taken (e.g. striving for a standard counselling procedure, "counselling checklist", "checklist after standard counselling"), minimising confounding.
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The standard counselling procedures will be discussed with all counsellors involved.
The different steps of the 592 testing and counselling procedures performed were respected (more than 90% of completion for every step).
Participants at high risk were re-invited after one and three years, when the screening, risk assessment, and lifestyle counselling procedures as described above were repeated.
It has been argued that counsellor support and supervision is important, as it helps to reduce stress, and thereby strengthens the quality of counselling procedures [ 18].
Before the study began, the PHNs of the intervention clinics were trained in the counselling procedures and the study arrangements (12 h in total) and the PHNs of the control clinics for the study arrangements (6 h in total) by the research group.
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