Lacour Robin A, Daniels Molly S, Westin Shannon N, Meyer Larissa A, Burke Catherine C, Burns Kimberly A, Kurian Shiney, Webb Nicki F, Pustilnik Terri B, Lu Karen H
Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-3721, USA.
Gynecol Oncol. 2008 Oct;111(1):132-6. doi: 10.1016/j.ygyno.2008.06.016. Epub 2008 Aug 6.
Few women with ovarian cancer undergo genetic testing for the Breast and Ovarian Cancer susceptibility genes, BRCA1 and BRCA2. With the prospect of BRCA-directed therapeutics, we investigated ovarian cancer patients' knowledge and willingness to undergo genetic testing.
All ovarian cancer patients seen in the Gynecology Center of a cancer center and a private clinic were asked to complete an anonymous questionnaire regarding knowledge and willingness to undergo BRCA testing. Women who had prior genetic testing were asked not to participate. Data was analyzed using Fisher's exact test.
Two-hundred and thirty seven ovarian cancer patients voluntarily completed the questionnaire. Fifty-five percent (131/237) of participants had not heard of BRCA testing. Of Caucasian respondents, 51% were unaware of BRCA testing, compared to 70% of Hispanic and 88% of African American respondents (p=0.008). Awareness was correlated with education (p<0.001). Eighty-nine percent of participants were willing to be tested if it would directly affect their therapy and 86.9% would be tested to benefit their family. Seventy-four percent of patients would pay 20% of the cost of testing, only 25.1% would pay in full.
A majority of women with ovarian cancer are not aware of the availability of BRCA testing. This lack of awareness is more profound in minorities. Despite lack of knowledge, most patients would undergo testing if it would impact their care. However, cost may be a barrier. Given the willingness of patients to undergo testing and the possibility of targeted therapy, clinicians who care for these patients should work to make appropriate genetic counseling referrals.
很少有卵巢癌女性会接受乳腺癌和卵巢癌易感基因BRCA1和BRCA2的基因检测。鉴于有针对BRCA的治疗方法,我们调查了卵巢癌患者对基因检测的了解情况和接受检测的意愿。
要求在一家癌症中心的妇科中心和一家私人诊所就诊的所有卵巢癌患者完成一份关于接受BRCA检测的知识和意愿的匿名问卷。曾接受过基因检测的女性被要求不参与。使用Fisher精确检验分析数据。
237名卵巢癌患者自愿完成了问卷。55%(131/237)的参与者从未听说过BRCA检测。在白人受访者中,51%不知道BRCA检测,相比之下,西班牙裔受访者中有70%、非裔美国受访者中有88%不知道(p = 0.008)。知晓情况与教育程度相关(p < 0.001)。89%的参与者表示如果检测会直接影响其治疗,他们愿意接受检测,86.9%的人表示接受检测是为了让家人受益。74%的患者愿意支付检测费用的20%,只有25.1%的患者愿意全额支付。
大多数卵巢癌女性不知道有BRCA检测。这种认知不足在少数族裔中更为严重。尽管缺乏相关知识,但如果检测会影响其治疗,大多数患者仍会接受检测。然而,费用可能是一个障碍。鉴于患者接受检测的意愿以及靶向治疗的可能性,治疗这些患者的临床医生应努力进行适当的基因咨询转诊。