Tilburt Jon C, James Katherine M, Sinicrope Pamela S, Eton David T, Costello Brian A, Carey Jantey, Lane Melanie A, Ehlers Shawna L, Erwin Patricia J, Nowakowski Katherine E, Murad Mohammad H
Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Hered Cancer Clin Pract. 2011 May 19;9(1):2. doi: 10.1186/1897-4287-9-2.
Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history.
We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk.
Of 1028 titles identified, 53 articles met our criteria. Most (92%) used an observational design and focused on women (70%) with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups) and few employed theory-driven analytic strategies to decipher interrelationships of factors.
Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although evolving, is still relatively undeveloped in several key topic areas including cancers other than breast and in specific populations. Future rigorous risk perception research using experimental designs and focused on cancers other than breast would advance the field.
遗传性癌症风险高于平均水平的患者对风险信息的处理方式可能与普通人群不同。然而，对于可能影响这些人群风险认知的临床、人口统计学或心理社会预测因素，我们知之甚少。本研究的目的是确定基于遗传学或家族病史处于癌症高风险组中与感知患癌风险相关的因素。
我们检索了从数据库建立至2009年4月的Ovid MEDLINE、Ovid Embase、Ovid PsycInfo和Scopus数据库，查找以英文发表的、以人类为研究对象且使用了“风险”和“癌症”核心概念的原创性研究。我们提取了关键信息，然后进一步筛选涉及因遗传风险而感知患癌风险的文章。
在识别出的1028篇标题中，53篇文章符合我们的标准。大多数（92%）采用观察性设计，且主要关注有乳腺癌家族史或考虑进行乳腺癌基因检测的女性（70%）。在这53项研究中，36项聚焦于未进行癌症风险基因检测的患者，17项包括了对已进行癌症风险基因检测患者的研究。癌症家族史、既往预防性检测和治疗以及较年轻的年龄与癌症风险认知相关。此外，对癌症可预防性和严重性的信念、诸如“监控型”人格等人格因素、处理数字信息的能力以及痛苦/担忧也与癌症风险认知相关。很少有研究涉及非乳腺癌或特定人口群体（如老年人或少数群体）的风险认知，且很少采用理论驱动的分析策略来解读各因素之间的相互关系。
有几个因素会影响癌症高风险患者的癌症风险认知。在包括非乳腺癌及特定人群在内的几个关键领域，用于描述和改善癌症高风险组风险认知的科学虽在不断发展，但仍相对不发达。未来采用实验设计并聚焦于非乳腺癌的严格风险认知研究将推动该领域的发展。
