Meiser B, Eisenbruch M, Barlow-Stewart K, Tucker K, Steel Z, Goldstein D
Department of Psychological Medicine, Block 4, Level 5, Royal North Shore Hospital, St Leonards, NSW 2065, Sydney, Australia.
J Med Genet. 2001 Jul;38(7):425-9. doi: 10.1136/jmg.38.7.425.
BACKGROUND: Anecdotal evidence suggests that people from non-Anglo-Celtic backgrounds are under-represented at familial cancer clinics in the UK, the USA, and Australia. This article discusses cultural beliefs as a potential key barrier to access, reviews previous empirical research on cultural aspects of cancer genetics, draws implications from findings, and sets a research agenda on the inter-relationships between culture, cancer genetics, and kinship. METHODS: The CD-ROM databases MEDLINE, PsychLIT, CINAHL, and Sociological Abstracts were searched from 1980 onwards. RESULTS: Cultural aspects of cancer genetics is the focus of an emerging body of publications. Almost all studies assessed African-American women with a family history of breast cancer and few studies included more diverse samples, such as Americans of Ashkenazi Jewish background or Hawaiian- and Japanese-Americans. Our analysis of published reports suggests several directions for future research. First, an increased focus on various Asian societies appears warranted. Research outside North America could explore the extent to which findings can be replicated in other multicultural settings. In addition, control group designs are likely to benefit from systematically assessing culture based beliefs and cultural identity in the "majority culture" group used for comparative purposes. CONCLUSION: More data on which to base the provision of culturally appropriate familial cancer clinic services to ethnically diverse societies are needed. Empirical data will assist with culturally appropriate categorisation of people from other cultures into risk groups based on their family histories and provide the basis for the development of culturally appropriate patient education strategies and materials.
背景:轶事证据表明,在英国、美国和澳大利亚的家族癌症诊所中,非盎格鲁 - 凯尔特背景的人群代表性不足。本文讨论文化信仰作为获取医疗服务的潜在关键障碍,回顾先前关于癌症遗传学文化方面的实证研究,从研究结果中得出启示,并设定关于文化、癌症遗传学和亲属关系之间相互关系的研究议程。 方法:检索了1980年起的光盘数据库MEDLINE、PsychLIT、CINAHL和社会学文摘数据库。 结果:癌症遗传学的文化方面是新兴一批出版物的焦点。几乎所有研究都评估了有乳腺癌家族史的非裔美国女性,很少有研究纳入更多样化的样本,如德系犹太人背景的美国人或夏威夷和日裔美国人。我们对已发表报告的分析提出了未来研究的几个方向。首先,似乎有必要更多地关注各种亚洲社会。北美以外的研究可以探索在其他多元文化环境中研究结果可被复制的程度。此外,对照组设计可能会受益于系统评估用于比较目的的“主流文化”群体中基于文化的信仰和文化身份。 结论:需要更多数据,以便为向多民族社会提供符合文化背景的家族癌症诊所服务提供依据。实证数据将有助于根据其他文化背景人群的家族史,将他们在文化上适当地归类为风险群体,并为制定符合文化背景的患者教育策略和材料提供基础。
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