Bjørnslett Merete, Dahl Alv A, Sørebø Øystein, Dørum Anne
Department of Molecular Oncology, Institute for Cancer Research, Oslo University Hospital, Norwegian Radium Hospital, PO Box 4953 Nydalen, 0424, Oslo, Norway.
Faculty of Medicine, University of Oslo, Oslo, Norway.
Fam Cancer. 2015 Dec;14(4):495-504. doi: 10.1007/s10689-015-9811-2.
An increasing demand for genetic testing has moved the procedure from highly selected at-risk individuals, now also including cancer patients for treatment associated testing. The heritable fraction of ovarian cancer is more than 10%, and our department has offered BRCA testing to such patients irrespective of family history since 2002. This study examined potential psychosocial distress associated with this procedure using The Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire and other patient-rated generic distress instruments. Patients were divided into four groups according to cancer risk: mutation carriers, own history of breast cancer and ovarian cancer, family history of breast cancer and/or ovarian cancer, and patients without family history. In a postal survey, 354 patients responded. Good acceptance of the MICRA was observed, and previously described good psychometric properties were confirmed. A significant association between MICRA total score and receiving a positive BRCA test result was found. No significant between-group differences were observed with generic distress instruments. Time since cancer diagnosis, test result, and survey showed no significant associations with MICRA scores. Internal consistencies of instruments were adequate. Exploratory and confirmatory factor analyses showed adequate fit indices for a three factor solution of the MICRA, but further refinement of the items should be considered. In conclusion, the specific types of worry and distress most relevant to receiving genetic testing irrespective of family history were not captured by the generic distress instruments. The MICRA was supported as a useful tool for detection of mental distress related to genetic testing and risk evaluation.
对基因检测的需求不断增加，使得该检测程序已从高度筛选的高危个体扩展到现在也包括癌症患者用于治疗相关检测。卵巢癌的遗传比例超过10%，自2002年以来，我们科室一直为这类患者提供BRCA检测，无论其家族史如何。本研究使用癌症风险评估多维影响问卷（MICRA）和其他患者自评的一般痛苦量表，检查了与该检测程序相关的潜在心理社会痛苦。根据癌症风险将患者分为四组：突变携带者、有乳腺癌和卵巢癌个人病史者、有乳腺癌和/或卵巢癌家族史者以及无家族史患者。在一项邮寄调查中，354名患者做出了回应。观察到患者对MICRA的接受度良好，并证实了其先前描述的良好心理测量特性。发现MICRA总分与BRCA检测结果呈阳性之间存在显著关联。使用一般痛苦量表未观察到组间有显著差异。癌症诊断后的时间、检测结果和调查显示与MICRA评分无显著关联。各量表的内部一致性良好。探索性和验证性因素分析显示，MICRA的三因素解决方案具有足够的拟合指数，但应考虑对项目进行进一步优化。总之，一般痛苦量表未涵盖与接受基因检测最相关的特定类型的担忧和痛苦，无论其家族史如何。MICRA被认为是检测与基因检测和风险评估相关的心理痛苦的有用工具。
