Rudichuk Lauren, Vogel Kristen J, Wang Chi-Hsiung, Helfand Brian T, Selkirk Christina G
Northwestern University, Chicago, IL.
GeneDx, Gaithersburg, MD.
Urology. 2017 Jan;99:180-185. doi: 10.1016/j.urology.2016.07.032. Epub 2016 Sep 16.
To assess urologists' knowledge and utilization of family history to determine prostate cancer (PC) screening and treatment recommendations.
Questionnaires that explored urologists' knowledge, frequency, and utilization of family history information for screening and treatment recommendations for PC were prospectively collected. Data were summarized and compared using descriptive statistics.
A total of 87 responses were collected, for a response rate of 60% (87 of 145). The majority of urologists reported that they always collect family history when discussing risk (95%) or screening (87%), and recommended earlier screening for men with family history of PC in comparison with men with no family history. Although only 57% reported always collecting family history when discussing treatment, the majority of respondents reported that a positive family history influenced their treatment recommendations. Eight percent of urologists would recommend prostatectomy for men diagnosed with low-grade, low-risk PC and no family history of PC vs 52% who would recommend the same course of treatment when the patient had at least 1 first-degree relative who died of the disease. Conversely, 91% of urologists would recommend active surveillance for men with low-grade, low-risk PC and no family history vs 47% for those with at least 1 first-degree relative who died of the disease.
The majority of urologists collect information on family history of PC. Despite the lack of literature to support that patients with familial PC require more aggressive treatment, urologists were more likely to recommend definitive therapies.
评估泌尿外科医生对家族史的了解及利用情况,以确定前列腺癌(PC)的筛查和治疗建议。
前瞻性收集了探索泌尿外科医生关于PC筛查和治疗建议的家族史信息的知晓情况、频率及利用情况的问卷。使用描述性统计对数据进行汇总和比较。
共收集到87份回复,回复率为60%(145份中的87份)。大多数泌尿外科医生报告称,他们在讨论风险(95%)或筛查(87%)时总是会收集家族史,并建议有PC家族史的男性比无家族史的男性更早进行筛查。尽管只有57%的医生报告在讨论治疗时总是收集家族史,但大多数受访者表示阳性家族史会影响他们的治疗建议。8%的泌尿外科医生会建议对诊断为低级别、低风险PC且无PC家族史的男性进行前列腺切除术,而当患者至少有1名死于该病的一级亲属时,这一比例为52%。相反,91%的泌尿外科医生会建议对低级别、低风险PC且无家族史的男性进行主动监测,而对于至少有1名死于该病的一级亲属的男性,这一比例为47%。
大多数泌尿外科医生会收集PC家族史信息。尽管缺乏文献支持家族性PC患者需要更积极的治疗,但泌尿外科医生更倾向于推荐确定性治疗方法。