Institute of Medical Genetics, Clinical Epidemiology Interdisciplinary Research Group, Cardiff University School of Medicine, Cardiff, UK.
Psychooncology. 2011 Sep;20(9):984-91. doi: 10.1002/pon.1807. Epub 2010 Aug 2.
There is little evidence regarding the long-term psychological implications of breast cancer risk assessment for women at moderate genetic risk. A follow-up study of a trial cohort was conducted to evaluate psychological outcomes and their predictors at 6-year follow-up. A further aim was to examine threshold scores for high cancer worry.
Questionnaires were sent to 384 women assessed as moderate risk during a UK trial of genetic assessment (TRACE). Measures included cancer worry, perceived risk, health behaviours, general anxiety, psychological morbidity, optimism, and background variables assessed during TRACE and at 6-year follow-up.
Reductions from baseline cancer worry and breast self-examination (BrSE) frequency were maintained 6 years after risk assessment, with relatively consistent levels over short- and long-term follow-up. Provision of risk information led to short-term reductions in perceived risk. During the 6-year period, 43% of women reported having made lifestyle changes and 27% had requested a mammogram. Baseline and post-risk cancer worry were the only significant predictors of long-term cancer worry. Greater worry at baseline predicted more frequent BrSE and higher perceived risk, but not lifestyle change or mammogram requests, at 6 years. Eighteen percent of women reported cancer worry above a threshold of 12.5 at long-term follow-up, compared with 30% at baseline.
Overall reductions in cancer worry following moderate risk assessment were maintained in the long term. However, women at risk of sustained high cancer worry should be identified at an early stage in the risk assessment process for more intensive psycho-educational intervention. Copyright © 2010 John Wiley & Sons, Ltd.
对于遗传风险中度的女性，有关乳腺癌风险评估的长期心理影响的证据很少。对一项试验队列进行了随访研究，以评估 6 年随访时的心理结果及其预测因素。另一个目的是检验高癌症担忧的阈值分数。
向在英国基因评估试验（TRACE）中评估为中度风险的 384 名妇女发送了问卷。测量包括癌症担忧、感知风险、健康行为、一般焦虑、心理发病率、乐观度以及在 TRACE 期间和 6 年随访期间评估的背景变量。
风险评估后 6 年，癌症担忧和乳房自我检查（BrSE）频率从基线开始降低，短期和长期随访的水平相对一致。提供风险信息导致感知风险短期降低。在 6 年期间，43%的女性报告生活方式发生了改变，27%要求进行乳房 X 光检查。基线和风险后癌症担忧是长期癌症担忧的唯一显著预测因素。基线时的担忧程度越高，预示着 BrSE 越频繁，感知风险越高，但不能预测生活方式的改变或乳房 X 光检查的请求。18%的女性报告在长期随访时癌症担忧超过 12.5 的阈值，而基线时为 30%。
中度风险评估后癌症担忧的总体降低在长期内得到维持。然而，在风险评估过程的早期阶段，应该识别出有持续高癌症担忧风险的女性，以便进行更密集的心理教育干预。
