Cancer Epidemiology and Services Research, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
Psychooncology. 2014 Jun;23(6):613-25. doi: 10.1002/pon.3476. Epub 2014 Jan 14.
Newly diagnosed patients with cancer require education about the disease, the available treatments and potential consequences of treatment. Greater understanding of cancer risk has been found to be associated with greater health-related quality of life, improved psychological adjustment and greater health-related behaviours. The aim of this sytematic review was to assess the effectiveness of educational interventions in improving subjective cancer risk perception and to appraise the quality of the studies.
We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) and prospective observational studies. Eligible studies were identified via Medline, PsycINFO, AMED, CINAHL and Embase databases. After screening titles and abstracts, two reviewers independently assessed the eligibility of 206 full-text articles.
Forty papers were included in the review; the majority of studies were conducted among breast cancer patients (n = 29) and evaluated the effect of genetic counselling on personal perceived risk (n = 25). Pooled results from RCTs (n = 12) showed that, both in the short and long term, educational interventions did not significantly influence risk perception level (standardised mean difference 0.05, 95% CI -0.24-0.34; p = 0.74) or accuracy (odds ratio = 1.96, 95% CI: 0.61-6.25; p = 0.26). Only one RCT reported a short-term difference in risk ratings (p = 0.01). Of prospective observational studies (n = 28), many did demonstrate changes in the level of perceived risk and improved risk accuracy and risk ratings in both the short and long term. However, only one (of three) observational studies reported a short-term difference in risk ratings (p < = 0.003).
Further development and investigation of educational interventions using good quality, RCTs are warranted.
新诊断出癌症的患者需要接受有关疾病、现有治疗方法以及治疗潜在后果的教育。人们发现，对癌症风险的认识越深入，与健康相关的生活质量就越高，心理适应能力也会得到改善，健康相关行为也会更加规范。本系统综述旨在评估教育干预措施在提高主观癌症风险认知方面的效果，并评价研究的质量。
我们对随机对照试验（RCT）和前瞻性观察研究进行了系统评价和荟萃分析。通过 Medline、PsycINFO、AMED、CINAHL 和 Embase 数据库确定了合格的研究。在筛选标题和摘要后，两名审查员独立评估了 206 篇全文文章的资格。
共有 40 篇论文被纳入综述，其中大多数研究是在乳腺癌患者中进行的（n=29），并评估了遗传咨询对个人感知风险的影响（n=25）。RCT 汇总结果（n=12）表明，短期和长期来看，教育干预并未显著影响风险感知水平（标准化均数差 0.05，95%置信区间 -0.24-0.34；p=0.74）或准确性（比值比 1.96，95%置信区间：0.61-6.25；p=0.26）。只有一项 RCT 报告了短期风险评分差异（p=0.01）。28 项前瞻性观察研究中，许多研究确实在短期和长期内改变了感知风险水平，并提高了风险准确性和风险评分。然而，只有一项观察性研究（三项中的一项）报告了短期风险评分差异（p≤0.003）。
需要进一步开发和研究使用高质量 RCT 的教育干预措施。
