Marcus A C, Ahnen D, Cutter G, Calonge N, Russell S, Sedlacek S M, Wood M, Manchester D, Fox L, McCaskill-Stevens W, Fairclough D, Hines S, Wenzel L, Osborn K
AMC Cancer Research Center, 1600 Pierce Street, Denver, Colorado, 80214, USA.
Prev Med. 1999 Mar;28(3):229-42. doi: 10.1006/pmed.1998.0408.
In this paper two large nationwide trials are described, both of which will test a comparable telephone-based counseling intervention to promote cancer screening among the first-degree relatives (FDRs) of breast and colorectal cancer patients. The unit of randomization will be the family unit of eligible FDRs. Access to FDRs will be obtained from their relatives with cancer. Selected intervention and design issues are reviewed, including how both projects will respond to FDRs who exhibit significant levels of cancer-specific anxiety or distress and how potential high-risk cancer families will be accommodated.
Pursuant to the development of both studies, two feasibility surveys were conducted to determine whether patients would grant access to their FDRs and whether the FDRS identified by these patients would be receptive to the telephone intervention.
Approximately 80% (106 of 132) of breast cancer patients agreed to provide access to their eligible FDRs when contacted on-site at participating hospitals and clinics. Of those subsequently selected for telephone follow-up (n = 95 or 90%), 80% (n = 76) were successfully contacted by telephone, and of these 97% (n = 74) provided the names and telephone numbers of their FDRs. Among colorectal cancer patients contacted on-site (n = 46), 96% (n = 44) agreed to provide access to their FDRs, and of those contacted by telephone (n = 33 or 75%), 91% (n = 30) provided the requested information about their FDRs. Once contacted, 95% of breast cancer FDRs (55 of 58) and 91% of colorectal cancer patients (51 of 56) endorsed the intervention strategy.
It is argued that this intervention, if proven effective, could provide an exportable strategy for reaching large numbers of high-risk individuals to promote cancer screening.
本文介绍了两项全国性大型试验，这两项试验都将测试一种类似的基于电话的咨询干预措施，以促进乳腺癌和结直肠癌患者的一级亲属（FDR）进行癌症筛查。随机分组的单位将是符合条件的FDR的家庭单位。将通过癌症患者的亲属获取FDR的联系方式。本文回顾了选定的干预措施和设计问题，包括两个项目将如何应对表现出显著程度的癌症特异性焦虑或痛苦的FDR，以及如何容纳潜在的高危癌症家庭。
根据两项研究的开展情况，进行了两项可行性调查，以确定患者是否会允许获取其FDR的联系方式，以及这些患者所确定的FDR是否会接受电话干预。
在参与研究的医院和诊所进行现场联系时，约80%（132例中的106例）的乳腺癌患者同意提供其符合条件的FDR的联系方式。在随后被选作电话随访的患者中（n = 95，即90%），80%（n = 76）通过电话成功联系上，其中97%（n = 74）提供了其FDR的姓名和电话号码。在现场联系的结直肠癌患者中（n = 46），96%（n = 44）同意提供其FDR的联系方式，在通过电话联系的患者中（n = 33，即75%），91%（n = 30）提供了所要求的有关其FDR的信息。一旦被联系上，95%的乳腺癌FDR（58例中的55例）和91%的结直肠癌FDR（56例中的51例）认可了干预策略。
有人认为，如果这种干预措施被证明有效，它可以为接触大量高危个体以促进癌症筛查提供一种可推广的策略。
