Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia.
Centre for Values, Ethics and the Law in Medicine, Sydney School of Public Health, The University of Sydney, Australia.
Br J Dermatol. 2017 Sep;177(3):779-790. doi: 10.1111/bjd.15744. Epub 2017 Jul 20.
Receiving information about genomic risk of melanoma might trigger conversations about skin cancer prevention and skin examinations.
To explore conversations prompted by receiving personalized genomic risk of melanoma with family, friends and health professionals.
We used a mixed-methods approach. Participants without a personal history and unselected for a family history of melanoma (n = 103, aged 21-69 years, 53% women) completed questionnaires 3 months after receiving a personalized melanoma genomic risk assessment. Semistructured interviews were undertaken with 30 participants in high, average and low genomic risk categories, and data were analysed thematically.
From the questionnaires, 74% of participants communicated their genomic risk information with family, and 49% with friends. Communication with a health professional differed by risk level: 41%, 16% and 12% for high, average and low risk, respectively (P = 0·01). Qualitative analysis showed that perceived 'shared risk' and perceived interest of family and friends were motivations for discussing risk or prevention behaviours. The information prompted conversations with family and health professionals about sun protection and skin checks, and general conversations about melanoma risk with friends. Reasons for not discussing with family included existing personal or family health concerns, or existing high levels of sun protection behaviour among family members.
Personalized melanoma genomic risk information can prompt risk-appropriate discussions about skin cancer prevention and skin examinations with family and health professionals. Sharing this information with others might increase its impact on melanoma prevention and skin examination behaviours, and this process could be used to encourage healthy behaviour change within families.
接收有关黑色素瘤基因组风险的信息可能会引发有关皮肤癌预防和皮肤检查的讨论。
探讨接收黑色素瘤个体化基因组风险后与家人、朋友和卫生专业人员进行的对话。
我们采用混合方法。103 名参与者无个人病史且未选择有黑色素瘤家族史(年龄 21-69 岁,女性占 53%),在接受个体化黑色素瘤基因组风险评估后 3 个月完成问卷调查。对高、中、低基因组风险类别的 30 名参与者进行半结构式访谈,并进行主题分析。
从问卷中可知,74%的参与者向家人传达了他们的基因组风险信息,49%的参与者向朋友传达了信息。与卫生专业人员的沟通因风险水平而异:高、中、低风险组分别为 41%、16%和 12%(P=0.01)。定性分析表明,感知到的“共同风险”以及家人和朋友的兴趣是讨论风险或预防行为的动机。该信息促使与家人和卫生专业人员讨论防晒和皮肤检查,并与朋友进行有关黑色素瘤风险的一般性讨论。与家人不讨论的原因包括现有的个人或家庭健康问题,或家庭成员中现有的高水平防晒行为。
黑色素瘤个体化基因组风险信息可以促进与家人和卫生专业人员就皮肤癌预防和皮肤检查进行风险适当的讨论。与他人分享此信息可能会增加其对黑色素瘤预防和皮肤检查行为的影响,并且这个过程可以用于鼓励家庭内的健康行为改变。