Glanz K, Grove J, Le Marchand L, Gotay C
Cancer Research Center of Hawaii, University of Hawaii, Honolulu 96813, USA.
Cancer Epidemiol Biomarkers Prev. 1999 Jul;8(7):635-9.
Scientific advances in cancer genetics, risk counseling, and management of high-risk individuals require information about familial cancer history. Because some people may not report, or may be unaware of, cancer in their families, it is important to examine the extent of underreporting of family history. We mailed a survey to first-degree relatives of patients with histologically confirmed diagnoses of colorectal cancer (CRC) before age 60 (n = 426, 77% response rate). Analyses examined the extent of underreporting of family history and its predictors (demographics, cancer characteristics, knowledge, and communication) and correlates (cancer worry, perceived risk). Logistic regression analysis was performed using generalized estimating equations to account for family clusters. Despite confirmed diagnosis of CRC in a parent or sibling, 25.4% of respondents reported having no first-degree relative with colon cancer. In multivariate models, the most significant predictor of awareness of a relative's CRC was the stage-at-diagnosis; also, males and those with low knowledge about colon cancer were significantly less aware. Awareness of a relative's CRC was associated with higher cancer worry and risk perception, and being a college graduate contributed independently to increased risk perception. Sole dependence on mailed self-administered questionnaires may lead to substantial underreporting of familial colon cancers, especially those that are in situ or localized.
癌症遗传学、风险咨询以及高危个体管理方面的科学进展需要有关家族癌症病史的信息。由于有些人可能不会报告其家族中的癌症情况，或者可能并未意识到家族中有癌症，因此了解家族病史报告不足的程度很重要。我们向60岁之前经组织学确诊为结直肠癌（CRC）患者的一级亲属邮寄了一份调查问卷（n = 426，回复率77%）。分析考察了家族病史报告不足的程度及其预测因素（人口统计学特征、癌症特征、知识和沟通情况）以及相关因素（癌症担忧、感知风险）。使用广义估计方程进行逻辑回归分析，以考虑家族聚类情况。尽管其父母或兄弟姐妹已确诊患有结直肠癌，但仍有25.4%的受访者报告称没有患结肠癌的一级亲属。在多变量模型中，亲属结直肠癌知晓情况的最显著预测因素是确诊时的分期；此外，男性以及对结肠癌了解较少的人知晓程度明显较低。亲属患结直肠癌的知晓情况与更高的癌症担忧和风险感知相关，而大学毕业则独立导致风险感知增加。仅依靠邮寄的自填式问卷可能会导致家族性结肠癌的报告严重不足，尤其是原位癌或局限性癌。
