Mueller Christine M, Mai Phuong L, Bucher Jaime, Peters June A, Loud Jennifer T, Greene Mark H
Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
BMC Complement Altern Med. 2008 Apr 30;8:17. doi: 10.1186/1472-6882-8-17.
Complementary and alternative medicine (CAM) use is well documented among breast cancer patients and survivors, but little evidence is available to describe rates and patterns of use among women at increased genetic risk of breast cancer.
A pre-visit telephone interview was conducted to ascertain CAM use among the BRCA mutation carriers enrolled in a high-risk breast cancer screening study. Participants were asked to report on their use of thirteen therapies within the year prior to enrollment into the study. Logistic regression was used to evaluate the association between various factors and CAM use in this population.
Among the 164 BRCA1 or BRCA2 mutation-positive (BRCA+) women in this analysis, 78% reported CAM use, with prayer and lifestyle diet being the two most commonly reported modalities. Many subjects used multiple CAM therapies, with 34% reporting use of three or more modalities. The most commonly used modalities were mind-body therapies and biologically-based practices, 61.6% and 51.8%, respectively. High-risk women were more likely to use CAM if they were older, more educated, more worried about ovarian cancer risk, or had a previous cancer diagnosis.
This study suggests that the prevalence of CAM use is high among BRCA mutation carriers, with frequency of use comparable to that of breast cancer patients and survivors. Given the high prevalence of CAM use in our subjects, especially biologically-based therapies including herbal supplements, whose safety and efficacy in relation to cancer risk are unknown, our study suggests that future research is necessary to clarify these risks, and that it is important for providers to inquire about and to discuss the pros and cons of CAM use with their BRCA+ patients.
补充和替代医学(CAM)在乳腺癌患者和幸存者中的使用已有充分记录,但关于乳腺癌遗传风险增加的女性的使用比率和模式的证据却很少。
进行了一次访前电话访谈,以确定参加高危乳腺癌筛查研究的BRCA突变携带者中CAM的使用情况。要求参与者报告在参加本研究前一年中使用的13种疗法。使用逻辑回归来评估该人群中各种因素与CAM使用之间的关联。
在本次分析的164名BRCA1或BRCA2突变阳性(BRCA+)女性中,78%报告使用了CAM,祈祷和生活方式饮食是最常报告的两种方式。许多受试者使用多种CAM疗法,34%报告使用了三种或更多种方式。最常用的方式是身心疗法和基于生物学的疗法,分别为61.6%和51.8%。高危女性如果年龄较大、受教育程度较高、更担心卵巢癌风险或曾有癌症诊断,则更有可能使用CAM。
本研究表明,BRCA突变携带者中CAM的使用率很高,使用频率与乳腺癌患者和幸存者相当。鉴于我们研究对象中CAM的高使用率,尤其是包括草药补充剂在内的基于生物学的疗法,其与癌症风险相关的安全性和有效性尚不清楚,我们的研究表明,未来有必要进行研究以阐明这些风险,并且对于医疗服务提供者来说,询问并与他们的BRCA+患者讨论CAM使用的利弊非常重要。