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BRCA1/2 基因检测后,自我报告的乳房 X 光检查使用率可能被高估。

Self-reported mammography use following BRCA1/2 genetic testing may be overestimated.

机构信息

Faculté de pharmacie, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Quebec, QC, G1V 0A6, Canada.

出版信息

Fam Cancer. 2012 Mar;11(1):27-32. doi: 10.1007/s10689-011-9490-6.

Abstract

Adherence to mammographic screening recommendations following BRCA1/2 testing is generally assessed through self-reports. However, the validity of self-reported mammography by women who had undergone BRCA1/2 genetic testing is still unknown. This study aimed to assess the validity of self-reported mammography use in the past 12 months among women who had undergone BRCA1/2 testing. Using a self-administered questionnaire, 307 women who never had cancer were asked 1 year following BRCA1/2 test result disclosure whether they undergone a mammography in the past 12 months. For each participant, this information was compared to that provided by the Quebec Health Insurance Board administrative data set for mammography claims during the same period, here considered as the gold standard. Sensitivity (Sn), specificity (Sp), predictive values, and Cohen's kappa (κ) were calculated. The robustness of these estimates was assessed using sensitivity analysis in which we varied the administrative data time lapses up to 18 months. Overall, the agreement between self-reports and administrative data was 88% (κ = 0.74). Among the 180 participants who had a mammography according to the administrative data, 172 adequately reported this information (Sn = 96%). Sp was moderate (76%), meaning that 24% of those who did not have a mammography reported one. Extending the time lapses to 18 months increased the Sp substantially (Sp = 90%). Self-report overestimates the use of mammography, mainly because women tend to minimize the elapsed time since their last mammography. Self-reports should be used cautiously to assess adherence to mammographic screening following BRCA1/2 testing.

摘要

BRCA1/2 检测后,对乳腺 X 线筛查建议的依从性通常通过自我报告来评估。然而,接受 BRCA1/2 基因检测的女性自我报告乳腺 X 线检查的准确性尚不清楚。本研究旨在评估接受 BRCA1/2 检测的女性在过去 12 个月内自我报告乳腺 X 线检查使用的准确性。使用自我管理问卷,在 BRCA1/2 检测结果公布后 1 年,从未患有癌症的 307 名女性被问及在过去 12 个月内是否进行过乳腺 X 线检查。对于每个参与者,将此信息与同一时期魁北克健康保险委员会管理数据集中提供的乳腺 X 线检查索赔信息进行比较,后者被视为金标准。计算了敏感性(Sn)、特异性(Sp)、预测值和 Cohen's kappa(κ)。通过敏感性分析评估了这些估计的稳健性,其中我们改变了管理数据的时间间隔,最长可达 18 个月。总体而言,自我报告和管理数据之间的一致性为 88%(κ=0.74)。在根据管理数据进行乳腺 X 线检查的 180 名参与者中,有 172 名充分报告了这一信息(Sn=96%)。Sp 适中(76%),这意味着 24%没有进行乳腺 X 线检查的人报告进行了检查。将时间间隔延长至 18 个月会大大提高 Sp(Sp=90%)。自我报告高估了乳腺 X 线检查的使用情况,主要是因为女性倾向于最小化上次乳腺 X 线检查以来的时间间隔。在评估 BRCA1/2 检测后乳腺 X 线筛查的依从性时,应谨慎使用自我报告。

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