1 Division of Cancer Prevention and Control, Centers for Disease Control and Prevention , Atlanta, Georgia .
2 Office on Smoking and Health, Centers for Disease Control and Prevention , Atlanta, Georgia .
J Womens Health (Larchmt). 2018 Feb;27(2):162-170. doi: 10.1089/jwh.2016.6140. Epub 2017 May 4.
Women younger than 45 years old have lower rates of breast cancer, but higher risk of recurrence and mortality after a cancer diagnosis. African American women are at risk for early onset and increased mortality; Ashkenazi Jewish women are at risk for genetic mutations leading to breast and ovarian cancer. Although younger women are encouraged to talk to doctors about their family history, little is known about these discussions.
In 2015, 167 women aged 18-44 years participated in 20 focus groups segmented by geographic location, age, race/ethnicity, and family history of breast and ovarian cancer. Transcript data were analyzed using NVivo 10 software.
Although the majority of women talked to their doctor about breast and ovarian cancer, these conversations were brief and unsatisfying due to a lack of detail. Topics included family history, breast cancer screening, and breast self-examination. Some women with and without family history reported that healthcare providers offered screening and early detection advice based on their inquiries. However, few women took action or changed lifestyle behaviors with the intent to reduce risk as a result of the conversations.
Conversations with young women revealed missed opportunities to: enhance patient-provider communication and increase knowledge about breast cancer screening and surveillance for higher risk patients. Physicians, allied health professionals, and the public health community can better assist women in getting accurate and timely information about breast and ovarian cancer, understanding their family history to determine risk, and increasing healthy behaviors.
年龄在 45 岁以下的女性患乳腺癌的比率较低,但在癌症诊断后,其复发和死亡的风险更高。非裔美国女性存在发病早和死亡率增加的风险;而阿什肯纳兹犹太女性则存在因基因突变而导致乳腺癌和卵巢癌的风险。尽管年轻女性被鼓励与医生讨论其家族病史,但对这些讨论却知之甚少。
2015 年,167 名年龄在 18-44 岁的女性参加了 20 个焦点小组,这些小组根据地理位置、年龄、种族/族裔以及乳腺癌和卵巢癌的家族史进行了细分。使用 NVivo 10 软件对转录数据进行了分析。
尽管大多数女性与医生讨论了乳腺癌和卵巢癌,但由于缺乏细节,这些对话简短且不令人满意。讨论的主题包括家族史、乳腺癌筛查和乳房自我检查。一些有家族病史和无家族病史的女性报告说,医护人员根据她们的询问提供了筛查和早期检测建议。然而,很少有女性因此类对话采取行动或改变生活方式行为以降低风险。
与年轻女性的对话揭示了错失的机会:增强医患沟通,增加对乳腺癌筛查和高危患者监测的了解。医生、辅助医疗专业人员和公共卫生界可以更好地帮助女性获得有关乳腺癌和卵巢癌的准确和及时信息,了解其家族史以确定风险,并增加健康行为。