Department of Human Genetics, Raboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Fam Cancer. 2011 Mar;10(1):51-7. doi: 10.1007/s10689-010-9387-9.
Current diagnostic practices have shortened the interval between colorectal cancer (CRC) diagnosis and genetic analysis for Lynch syndrome by MSI-testing. We studied the relation of time between MSI-testing since CRC diagnosis (MSI-CRC interval) and psychological distress. We performed a cross-sectional study in 89 patients who had previously been treated for CRC. Data were collected during MSI-testing after genetic counseling. Psychological distress was measured with the IES, the SCL-90 and the POMS; social issues with the ISS, ISB and the ODHCF. The median time of MSI-CRC interval was 24 months (range 0-332), with 23% of the patients diagnosed less than 12 months and 42% more than 36 months prior to MSI-testing. In 34% of the patients cancer specific distress was high (IES scores >26). Mean psychopathology (SCL-90) scores were low, mean mood states (POMS) scores were moderate. Interval MSI-CRC was not related to psychological distress. High cancer specific distress was reported by 24% of patients diagnosed with CRC less than 12 months ago versus 39 and 35% by those diagnosed between 12 and 36 months and more than 36 months ago respectively. Distress was positively related to female gender (P = 0.04), religiousness (P = 0.01), low social support (P = 0.02) and difficulties with family communication (P < 0.001). Shortened time interval between CRC diagnosis and MSI-testing is not associated with higher psychological distress. Females, religious persons, those having low social support and those reporting difficulties communicating hereditary colorectal cancer with relatives are at higher risk for psychological distress.
目前的诊断实践通过微卫星不稳定性（MSI）检测缩短了结直肠癌（CRC）诊断和林奇综合征基因分析之间的间隔时间。我们研究了 MSI 检测与心理困扰之间的关系。我们对 89 名先前接受过 CRC 治疗的患者进行了横断面研究。数据是在遗传咨询后进行 MSI 检测期间收集的。心理困扰用IES、SCL-90 和 POMS 进行测量；社会问题用 ISS、ISB 和 ODHCF 进行测量。MSI-CRC 间隔的中位数为 24 个月（范围 0-332），其中 23%的患者在 MSI 检测前 12 个月内被诊断出，42%的患者在 36 个月前被诊断出。在 34%的患者中，癌症特异性困扰较高（IES 评分>26）。平均心理病理学（SCL-90）评分较低，平均情绪状态（POMS）评分中等。MSI-CRC 间隔与心理困扰无关。24%的患者在被诊断出 CRC 不到 12 个月前报告有较高的癌症特异性困扰，而在被诊断出 12-36 个月和 36 个月前的患者中，分别有 39%和 35%报告有较高的癌症特异性困扰。困扰与女性性别（P = 0.04）、宗教信仰（P = 0.01）、低社会支持（P = 0.02）和与家庭沟通困难（P < 0.001）呈正相关。CRC 诊断和 MSI 检测之间的时间间隔缩短与较高的心理困扰无关。女性、宗教人士、社会支持较低和报告与亲属遗传结直肠癌沟通困难的人患心理困扰的风险较高。
