Price Melanie Anne, Butow Phyllis Noami, Lo Sing Kai, Wilson Judy
Medical Psychology Research Unit, School of Psychology, Brennan MacCallum Building (A18), University of Sydney, Sydney, Australia.
J Genet Couns. 2007 Oct;16(5):635-44. doi: 10.1007/s10897-007-9105-4. Epub 2007 Sep 9.
Some women at increased familial risk of breast cancer experience elevated levels of cancer-specific worry, which can possibly act as a barrier to screening, and may be a significant factor in decisions regarding risk-reducing surgery. The aim of this study was to comprehensively examine predictors of cancer-specific worry in high risk women and to test a model which proposes that perceived breast cancer risk mediates the impact of other factors on worry. 1,437 unaffected women from high risk breast cancer families completed questionnaires and interviews. Path analysis was used to test the model of potential predictors of cancer worry, including familial, personal and psychological variables, mediated via perceived cancer risk. Levels of cancer-specific worry were generally low despite an average perceived risk of 50.3%. The goodness-of-fit of the proposed model was poor, explaining only 9% of the variance for perceived risk and 10% of the variance for cancer specific worry. An alternative model of a direct relationship between all of the predictor variables and cancer worry, explained 24% of the variation in cancer worry. General anxiety, perceived risk, the stressful impact of recent cancer related events, a relative risk greater than 10, being closer in age to the youngest breast cancer diagnosis in family, and knowledge of personal mutation status, all independently contributed to cancer worry. Addressing general affective responses, experiences of recent cancer related events, in addition to education about personal risk, should be considered in counselling women with elevated cancer worry. Risk perception appears to act independently of other factors in its formulation and impact on cancer worry. Further research on the way in which women come to perceive their risk is indicated.
一些乳腺癌家族风险增加的女性经历了特定癌症担忧水平的升高，这可能成为筛查的障碍，并且可能是决定是否进行降低风险手术的一个重要因素。本研究的目的是全面检查高风险女性中特定癌症担忧的预测因素，并测试一个模型，该模型提出感知到的乳腺癌风险介导其他因素对担忧的影响。1437名来自高风险乳腺癌家族的未受影响女性完成了问卷调查和访谈。路径分析用于测试癌症担忧潜在预测因素的模型，包括家族、个人和心理变量，通过感知到的癌症风险进行介导。尽管平均感知风险为50.3%，但特定癌症担忧水平总体较低。所提出模型的拟合优度较差，仅解释了感知风险方差的9%和特定癌症担忧方差的10%。所有预测变量与癌症担忧之间直接关系的替代模型解释了癌症担忧变异的24%。一般焦虑、感知风险、近期与癌症相关事件的压力影响、相对风险大于10、年龄更接近家族中最年轻乳腺癌诊断的年龄以及个人突变状态的知识，均独立导致癌症担忧。在为癌症担忧水平升高的女性提供咨询时，应考虑解决一般情感反应、近期与癌症相关事件的经历，以及关于个人风险的教育。风险感知在其形成和对癌症担忧的影响方面似乎独立于其他因素起作用。表明需要进一步研究女性如何开始感知自己的风险。
