Gwyn Karin, Vernon Sally W, Conoley Patrick M
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Cancer Epidemiol Biomarkers Prev. 2003 Feb;12(2):96-102.
Because few studies have addressed the intention to pursue testing for breast cancer susceptibility among women in the general population, we examined whether women due for routine mammography would want such testing and what factors might impact on their decision to pursue testing. A questionnaire was mailed to women > or =50 years of age who had undergone a screening mammogram 12 to 14 months before the study. Univariate and multivariable analyses were conducted to identify factors associated with intention to pursue genetic testing. Approximately 41% of respondents probably or definitely intended to pursue testing. In univariate analysis, the intention to undergo testing was not significantly associated with age, education, marital status, potential effects on health or life insurance, or physician recommendation. Although significant in univariate analysis, family history of breast cancer and ethnicity were not significant in multivariable analysis. In both univariate and multivariable analysis, factors significantly associated with intention to undergo testing included awareness of genetic testing, cancer worry, and insurance coverage of testing cost. Intention also was associated with the respondent wanting to know whether she possessed the susceptibility gene, even if that knowledge would not impact on options for early detection or treatment. Given the relatively high level of interest in testing among women at average risk of breast cancer, these results may help health care professionals educate and counsel women regarding the appropriate use of genetic testing as well as breast cancer risk factors.
由于很少有研究探讨普通人群中女性进行乳腺癌易感性检测的意愿,我们调查了应接受常规乳房X线检查的女性是否希望进行此类检测,以及哪些因素可能影响她们进行检测的决定。我们向年龄≥50岁、在研究前12至14个月接受过乳房X线筛查的女性邮寄了一份问卷。进行单因素和多因素分析以确定与进行基因检测意愿相关的因素。约41%的受访者可能或肯定打算进行检测。在单因素分析中,进行检测的意愿与年龄、教育程度、婚姻状况、对健康或人寿保险的潜在影响或医生建议均无显著关联。尽管在单因素分析中具有显著性,但乳腺癌家族史和种族在多因素分析中并不显著。在单因素和多因素分析中,与进行检测意愿显著相关的因素包括对基因检测的认知、癌症担忧以及检测费用的保险覆盖情况。意愿还与受访者想知道自己是否携带易感基因有关,即使该信息不会影响早期检测或治疗方案。鉴于乳腺癌平均风险女性对检测的兴趣相对较高,这些结果可能有助于医疗保健专业人员就基因检测的合理使用以及乳腺癌风险因素对女性进行教育和咨询。