Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
Cancer Epidemiol Biomarkers Prev. 2011 Mar;20(3):522-9. doi: 10.1158/1055-9965.EPI-10-1045. Epub 2011 Feb 9.
Whether to return individual research results from cancer genetics studies is widely debated, but little is known about how participants respond to results disclosure or about its time and cost burdens on investigators.
We recontacted participants at one site of a multicenter genetic epidemiologic study regarding their CDKN2A gene test results and implications for melanoma risk. Interested participants were disclosed their results by telephone and followed for 3 months.
Among 39 patients approached, 27 were successfully contacted, and 19 (70% uptake) sought results, including three with mutations. Prior to disclosure, participants endorsed numerous benefits of receiving results (mean=7.7 of 9 posed), including gaining information relevant to their children's disease risk. Mean psychological well-being scores did not change from baseline, and no decreases to melanoma prevention behaviors were noted. Fifty-nine percent of participants reported that disclosure made participation in future research more likely. Preparation for disclosure required 40 minutes and $611 per recontact attempt. An additional 78 minutes and $68 was needed to disclose results.
Cancer epidemiology research participants who received their individual genetic research results showed no evidence of psychological harm or false reassurance from disclosure and expressed strong trust in the accuracy of results. Burdens to our investigators were high, but protocols may differ in their demands and disclosure may increase participants' willingness to enroll in future studies.
Providing individual study results to cancer genetics research participants poses potential challenges for investigators, but many participants desire and respond positively to this information.
是否要公布癌症遗传学研究的个体研究结果存在广泛争议,但对于参与者对结果披露的反应,以及对调查人员的时间和成本负担,知之甚少。
我们重新联系了一个多中心遗传流行病学研究的一个站点的参与者,了解他们的 CDKN2A 基因检测结果及其对黑色素瘤风险的影响。感兴趣的参与者通过电话获得了他们的结果,并进行了 3 个月的随访。
在接触的 39 名患者中,有 27 名成功联系上,19 名(70%的参与率)寻求结果,其中包括 3 名有突变的患者。在披露之前,参与者认可了许多接受结果的好处(提出的 9 个好处中的 7.7 个),包括获得与子女疾病风险相关的信息。心理健康得分基线没有变化,黑色素瘤预防行为也没有下降。59%的参与者表示,披露结果使他们更有可能参与未来的研究。披露前的准备工作需要 40 分钟,每次重新联系的费用为 611 美元。披露结果还需要额外的 78 分钟和 68 美元。
接受个人遗传研究结果的癌症流行病学研究参与者没有证据表明心理伤害或披露带来的虚假安慰,并且对结果的准确性表示强烈信任。我们调查人员的负担很高,但协议可能在需求上有所不同,披露可能会增加参与者参与未来研究的意愿。
向癌症遗传学研究参与者提供个体研究结果对调查人员提出了潜在挑战,但许多参与者渴望并对这些信息做出积极回应。