Leblond Débora, Brédart Anne, Dolbeault Sylvie, De Pauw Antoine, Stoppa-Lyonnet Dominique, Sultan Serge
Institut Curie, unité de psycho-oncologie, département interdisciplinaire de soins de support pour le patient en oncologie, 26, rue d'Ulm, 75248 Paris, France.
Bull Cancer. 2012 Jun;99(6):673-84. doi: 10.1684/bdc.2012.1590.
This study aims to determine accuracy between perceived risk of genetic predisposition and objective estimation of this risk, and its associated factors in women, probands affected with breast cancer. Perception of this risk, absolute and comparative, was confronted with objective estimation. Emotional distress and knowledge postcounseling were measured, respectively by the Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES) and the Breast Genetic Counseling Knowledge Questionnaire (BGKQ). On 213 eligible consultants, the 173 questionnaires (81.2%) analyzed revealed an inaccuracy of perception of absolute and comparative risks in 50 and 55.3%, respectively. An unsignificant tendency to overestimate the absolute risk (p = 0,08) and a significant underestimation of comparative risk (p < 0.001) appear. The inaccuracy of the perception of absolute risk is associated with greater distress (β = 0.150) and a lower educational level (β = -0.164), while the comparative risk is associated with higher knowledge (β = 0.208), higher level of education (β = 0.176) and a younger age (β = -0.151). Living in couple is a factor of inaccuracy of both form of risk assessment (β = 0.189, β = 0.147). While the adequacy of the perceived risk of carrying a mutation in a BRCA1 /2 should promote an informed decision about genetic testing and anticipation of its outcome, a large number of consultants does not apprehend this risk correctly when they have emotional distress and despite knowledge of the risk of breast cancer.
本研究旨在确定乳腺癌女性患者（先证者）对遗传易感性风险的感知与该风险客观评估之间的准确性及其相关因素。将这种风险的绝对和相对感知与客观评估进行对比。分别通过医院焦虑抑郁量表（HADS）、事件影响量表（IES）和乳腺遗传咨询知识问卷（BGKQ）来测量咨询后的情绪困扰和知识水平。在213名符合条件的咨询者中，分析的173份问卷（81.2%）显示，分别有50%和55.3%的人对绝对风险和相对风险的感知不准确。出现了高估绝对风险的不显著趋势（p = 0.08）和对相对风险的显著低估（p < 0.001）。绝对风险感知的不准确与更大的困扰（β = 0.150）和较低的教育水平（β = -0.164）相关，而相对风险则与更高的知识水平（β = 0.208）、更高的教育水平（β = 0.176）和更年轻的年龄（β = -0.151）相关。处于恋爱关系是两种风险评估形式不准确的一个因素（β = 0.189，β = 0.147）。虽然对携带BRCA1/2突变风险的感知充分性应促进关于基因检测的明智决策及其结果的预期，但当咨询者有情绪困扰且尽管了解乳腺癌风险时，仍有大量人不能正确理解这种风险。
