Codori Ann-Marie, Waldeck Tracy, Petersen Gloria M, Miglioretti Diana, Trimbath Jill D, Tillery Miriam A
Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Genet Couns. 2005 Apr;14(2):119-32. doi: 10.1007/s10897-005-4062-2.
Genetic counseling may turn risk information into cancer prevention behavior by modifying health beliefs and cancer-related distress. We assessed the effect of genetic counseling on these factors in 101 adult first-degree-relatives of colorectal cancer patients from families with known or suspected hereditary nonpolyposis colorectal cancer. Before counseling and once afterward, subjects completed self-report measures of perceived lifetime risk and cancer-distress. Most persons overestimated their cancer risk, and higher perceived risk was associated with believing that colorectal cancer cannot be prevented. Individual perceived risk changed after counseling, although mean perceived risk was unchanged. After adjusting for baseline risk, older persons and those with higher estimated objective cancer risk had larger postcounseling decreases. Distress after counseling was positively correlated with baseline distress and anxiety symptoms, and inversely correlated with tolerance for ambiguity. The findings suggest counseling interventions that should increase the likelihood of screening and offer hypotheses for future research.
遗传咨询可通过改变健康观念和癌症相关困扰，将风险信息转化为癌症预防行为。我们评估了遗传咨询对101名来自已知或疑似遗传性非息肉病性结直肠癌家庭的成年结直肠癌患者一级亲属的这些因素的影响。在咨询前及咨询后一次，受试者完成了感知终身风险和癌症困扰的自我报告测量。大多数人高估了他们的癌症风险，而更高的感知风险与认为结直肠癌无法预防有关。咨询后个体感知风险发生了变化，尽管平均感知风险没有改变。在调整基线风险后，年龄较大者和估计客观癌症风险较高者咨询后下降幅度更大。咨询后的困扰与基线困扰和焦虑症状呈正相关，与对模糊性的耐受性呈负相关。研究结果提示了咨询干预措施，应增加筛查的可能性，并为未来研究提供假设。
