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年轻乳腺癌女性患者癌症基因检测结果家庭沟通中的心理社会和临床因素

Psychosocial and Clinical Factors Associated with Family Communication of Cancer Genetic Test Results among Women Diagnosed with Breast Cancer at a Young Age.

作者信息

Elrick Ashley, Ashida Sato, Ivanovich Jennifer, Lyons Sarah, Biesecker Barbara B, Goodman Melody S, Kaphingst Kimberly A

机构信息

Department of Communication, University of Utah, 255 Central Campus Drive, LNCO, Salt Lake City, UT, 84112, USA.

College of Public Health, University of Iowa, Iowa City, IA, USA.

出版信息

J Genet Couns. 2017 Feb;26(1):173-181. doi: 10.1007/s10897-016-9995-0. Epub 2016 Jul 16.

Abstract

Genetic test results have medical implications beyond the patient that extend to biological family members. We examined psychosocial and clinical factors associated with communication of genetic test results within families. Women (N = 1080) diagnosed with breast cancer at age 40 or younger completed an online survey; 920 women that reported prior cancer genetic testing were included in analysis. We examined the proportion of immediate family members to whom they communicated genetic test results, and built multivariable regression models to examine clinical and psychosocial variables associated with the proportion score. Participants were most likely to communicate test results to their mother (83 %) and least likely to their son (45 %). Participants who carried a BRCA mutation (OR = 1.34; 95 % CI = 1.06, 1.70), had higher interest in genomic information (OR = 1.55; 95 % CI = 1.26, 1.91) and lower genetic worry (OR = 0.91; 95 % CI = 0.86, 0.96) communicated genetic test results to a greater proportion of their immediate family members. Participants with a BRCA1/2 mutation shared their genetic test results with more male family members (OR = 1.72; 95 % CI = 1.02, 2.89). Our findings suggest that patients with high worry about genetic risks, low interest in genomic information, or receive a negative genetic test result will likely need additional support to encourage family communication.

摘要

基因检测结果对患者的医学影响不仅限于患者自身,还会延伸至其生物学家庭成员。我们研究了与家庭内部基因检测结果沟通相关的心理社会和临床因素。40岁及以下被诊断为乳腺癌的女性(N = 1080)完成了一项在线调查;920名报告曾进行癌症基因检测的女性被纳入分析。我们考察了她们向直系家庭成员通报基因检测结果的比例,并构建多变量回归模型来研究与该比例得分相关的临床和心理社会变量。参与者最有可能将检测结果告知母亲(83%),而告知儿子的可能性最小(45%)。携带BRCA突变的参与者(OR = 1.34;95% CI = 1.06,1.70)、对基因组信息兴趣较高的参与者(OR = 1.55;95% CI = 1.26,1.91)以及基因担忧较低的参与者(OR = 0.91;95% CI = 0.86,0.96)会将基因检测结果告知更大比例的直系家庭成员。携带BRCA1/2突变的参与者与更多男性家庭成员分享了他们的基因检测结果(OR = 1.72;95% CI = 1.02,2.89)。我们的研究结果表明,对基因风险高度担忧、对基因组信息兴趣较低或基因检测结果为阴性的患者可能需要额外的支持来促进家庭沟通。

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