Vornanen Marleena, Konttinen Hanna, Kääriäinen Helena, Männistö Satu, Salomaa Veikko, Perola Markus, Haukkala Ari
Department of Social Research, University of Helsinki, Unioninkatu 37, P.O. Box 54, 00014 Helsinki, Finland.
National Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, 00271 Helsinki, Finland.
Prev Med. 2016 Sep;90:177-83. doi: 10.1016/j.ypmed.2016.06.027. Epub 2016 Jun 25.
Family history is a useful and inexpensive tool to assess risks of multifactorial diseases. Family history enables individualized disease prevention, but its effects on perceived risks of various diseases need to be understood in more detail. We examined how family history relates to perceived risk of diabetes mellitus, cardiovascular disease (CVD), cancer, and depression, and whether these associations are independent of or moderated by sociodemographic factors, health behavior/weight status (smoking, alcohol consumption, physical activity, BMI [kg/m(2)]), or depressive symptoms.
Participants were Finnish 25-74-year-olds (N=6258) from a population-based FINRISK 2007 study. Perceived absolute lifetime risks (Brewer et al., 2004; Becker, 1974; Weinstein and Nicolich, 1993; Guttmacher et al., 2004; Yoon et al., 2002) and first-degree family history of CVD, diabetes, cancer and depression, and health behaviors were self-reported. Weight and height were measured in a health examination.
Family history was most prevalent for cancer (36.7%), least for depression (19.6%). Perceived risk mean was highest for CVD (2.8), lowest for depression (2.0). Association between family history and perceived risk was strongest for diabetes (β=0.34, P<0.001), weakest for depression (β=0.19, P<0.001). Adjusting for sociodemographics, health behavior, and depressive symptoms did not change these associations. The association between family history and perceived risk tended to be stronger among younger than among older adults, but similar regardless of health behaviors or depressive symptoms.
Association between family history and perceived risk varies across diseases. People's current understandings on heritability need to be acknowledged in risk communication practices. Future research should seek to identify effective strategies to combine familial and genetic risk communication in disease prevention.
家族病史是评估多因素疾病风险的一种有用且经济的工具。家族病史有助于进行个性化疾病预防,但需要更详细地了解其对各种疾病感知风险的影响。我们研究了家族病史与糖尿病、心血管疾病(CVD)、癌症和抑郁症的感知风险之间的关系,以及这些关联是否独立于社会人口统计学因素、健康行为/体重状况(吸烟、饮酒、体育活动、体重指数[kg/m²])或抑郁症状,或者是否受其调节。
参与者是来自基于人群的2007年芬兰全国 FINRISK 研究的25 - 74岁芬兰人(N = 6258)。通过自我报告获取感知的绝对终生风险(Brewer等人,2004年;Becker,1974年;Weinstein和Nicolich,1993年;Guttmacher等人,2004年;Yoon等人,2002年)以及CVD、糖尿病、癌症和抑郁症的一级家族病史和健康行为。在健康检查中测量体重和身高。
家族病史在癌症中最为普遍(36.7%),在抑郁症中最少见(19.6%)。CVD的感知风险均值最高(2.8),抑郁症的最低(2.0)。家族病史与感知风险之间的关联在糖尿病中最强(β = 0.34,P < 0.001),在抑郁症中最弱(β = 0.19,P < 0.001)。对社会人口统计学、健康行为和抑郁症状进行调整后,这些关联并未改变。家族病史与感知风险之间的关联在年轻人中往往比在老年人中更强,但无论健康行为或抑郁症状如何,情况都相似。
家族病史与感知风险之间的关联因疾病而异。在风险沟通实践中,需要承认人们目前对遗传度的理解。未来的研究应寻求确定在疾病预防中结合家族和遗传风险沟通的有效策略。