Isaacs Claudine, Peshkin Beth N, Schwartz Marc, Demarco Tiffani A, Main David, Lerman Caryn
Department of Medical Oncology, Lombardi Cancer Center, Georgetown University, Washington, DC 20007-2197, USA.
Breast Cancer Res Treat. 2002 Jan;71(2):103-12. doi: 10.1023/a:1013800409238.
Studies in women with a family history of cancer demonstrate a wide variability in the uptake of cancer screening measures. Little data exist regarding the breast and ovarian cancer screening practices of women who are members of hereditary breast cancer families. In order to address this issue, we examined the screening behaviors and the determinants of screening in a clinic based group of 216 women with a strong family history of breast or ovarian cancer who were participating in a free genetic counseling and testing research program. At baseline, prior to obtaining genetic counseling or testing, 50% of women ages 30-39, 83% of those age 40-49, 69% of those 50-64, and 53% of those >65 reported having a mammogram in the prior year. Adherence to mammography recommendations was correlated with age, number of relatives with breast cancer, and income. Twenty percent of participants had at least one CA- 125 performed and 31 % had ever obtained a screening ultrasound. Having at least one relative with ovarian cancer was very strongly associated with ovarian cancer screening [OR = 12.3, 95% CI = 4.6-33 for CA-125; OR=4.9, 95% CI=2.4, 10.1 for ultrasound]. No association between cancer worries/distress and either breast or ovarian cancer screening was found. In conclusion, the breast and ovarian screening uptake in healthy women from hereditary breast cancer families is suboptimal, even for women over age 50, for whom annual mammography is clearly indicated. These findings indicate a need for better education about screening guidelines for high-risk women.
对有癌症家族史女性的研究表明，在癌症筛查措施的采用方面存在很大差异。关于遗传性乳腺癌家族女性的乳腺癌和卵巢癌筛查实践的数据很少。为了解决这个问题，我们在一个诊所组中对216名有强烈乳腺癌或卵巢癌家族史且参与免费遗传咨询和检测研究项目的女性的筛查行为及其决定因素进行了研究。在基线时，即在获得遗传咨询或检测之前，30 - 39岁的女性中有50%、40 - 49岁的女性中有83%、50 - 64岁的女性中有69%以及65岁以上的女性中有53%报告在前一年进行了乳房X光检查。对乳房X光检查建议的依从性与年龄、患乳腺癌的亲属数量和收入相关。20%的参与者至少进行过一次CA - 125检测，31%的人曾进行过筛查超声检查。有至少一名卵巢癌亲属与卵巢癌筛查密切相关[CA - 125检测的比值比（OR）= 12.3，95%置信区间（CI）= 4.6 - 33；超声检查的OR = 4.9，95% CI = 2.4，10.1]。未发现癌症担忧/困扰与乳腺癌或卵巢癌筛查之间存在关联。总之，遗传性乳腺癌家族中的健康女性，即使是50岁以上明确建议每年进行乳房X光检查的女性，其乳腺癌和卵巢癌筛查率也不理想。这些发现表明需要对高危女性的筛查指南进行更好的教育。
