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癌症患者对于接收通过下一代测序获得的主动提供的基因信息的意向。

Cancer patients' intentions towards receiving unsolicited genetic information obtained using next-generation sequencing.

作者信息

Bijlsma Rhodé M, Wessels Hester, Wouters Roel H P, May Anne M, Ausems Margreet G E M, Voest Emile E, Bredenoord Annelien L

机构信息

Department of Medical Oncology, Cancer Center, University Medical Center Utrecht, Q05.4.300, PO Box 85500, 3508 GA, Utrecht, The Netherlands.

Department of Corporate Communications, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

Fam Cancer. 2018 Apr;17(2):309-316. doi: 10.1007/s10689-017-0033-7.

Abstract

Next-generation sequencing (NGS) can be used to generate information about a patient's tumour and personal genome. This powerful diagnostic tool provides solicited and unsolicited hereditary genetic (risk) information that could have consequences for cancer patients and their quality of life. A well-defined approach for returning appropriate genetic risk information is needed in personalized cancer care. A qualitative design with semi-structured interviews was used. We conducted interviews with 24 Dutch patients with different types of cancer, both NGS-experienced and NGS-inexperienced, to learn their intentions, needs and preferences towards receiving unsolicited genetic information obtained using NGS. Almost all participants had a positive attitude towards receiving unsolicited findings. After receiving comprehensive background information on NGS, including a binning model of four categories of unsolicited findings, most participants preferred to receive only subsets of genetic information. Their main concern was their own and others' (including family members) ability to cope with (the increased risk of having) a genetic disorder. Providing background information gave cancer patients the opportunity to select subsets of findings and increased their ability to make an informed choice. Special attention is needed for social and emotional factors to support the patients themselves and when communicating test results with their family members.

摘要

下一代测序(NGS)可用于生成有关患者肿瘤和个人基因组的信息。这种强大的诊断工具会提供主动和被动的遗传(风险)信息,这可能会对癌症患者及其生活质量产生影响。在个性化癌症护理中,需要一种明确的方法来反馈适当的遗传风险信息。我们采用了半结构化访谈的定性设计。我们对24名患有不同类型癌症的荷兰患者进行了访谈,这些患者既有NGS经验丰富的,也有经验不足的,以了解他们对于接收通过NGS获得的主动遗传信息的意图、需求和偏好。几乎所有参与者对于接收主动发现结果都持积极态度。在收到有关NGS的全面背景信息,包括四类主动发现结果的分类模型后,大多数参与者更倾向于只接收部分遗传信息。他们主要担心自己及他人(包括家庭成员)应对(患)遗传疾病(风险增加)的能力。提供背景信息使癌症患者有机会选择部分发现结果,并增强了他们做出明智选择的能力。在支持患者本人以及与他们的家庭成员沟通检测结果时,需要特别关注社会和情感因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/486c/5893692/ac51d4c3ef51/10689_2017_33_Fig1_HTML.jpg

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