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转诊至癌症遗传咨询:移民身份和患者的教育背景有影响吗?

Referral to cancer genetic counseling: do migrant status and patients' educational background matter?

作者信息

van der Giessen J A M, van Riel E, Velthuizen M E, van Dulmen A M, Ausems M G E M

机构信息

Department of Genetics, Division of Biomedical Genetics, University Medical Center Utrecht, PO Box 85090, Utrecht, 3508 AB, The Netherlands.

NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.

出版信息

J Community Genet. 2017 Oct;8(4):303-310. doi: 10.1007/s12687-017-0326-4. Epub 2017 Sep 4.

Abstract

Participation rates in cancer genetic counseling differ among populations, as patients with a lower educational background and migrant patients seem to have poorer access to it. We conducted a study to determine the present-day educational level and migrant status of counselees referred to cancer genetic counseling. We assessed personal characteristics and demographics of 731 newly referred counselees. Descriptive statistics were used to describe these characteristics. The results show that about 40% of the counselees had a high educational level and 89% were Dutch natives. Compared to the Dutch population, we found a significant difference in educational level (p = < 0.01) and migrant status (p = < 0.001). This suggests disparities in cancer genetic counseling and as a result of that, suboptimal care for vulnerable groups. Limited health literacy is likely to pose a particular challenge to cancer genetic counseling for counselees with a lower education or a migrant background. Our study points to considerable scope for improvement in referring vulnerable groups of patients for cancer genetic counseling.

摘要

癌症遗传咨询的参与率在不同人群中存在差异,因为教育背景较低的患者和移民患者获得咨询的机会似乎更少。我们开展了一项研究,以确定转介至癌症遗传咨询的咨询对象当前的教育水平和移民身份。我们评估了731名新转介咨询对象的个人特征和人口统计学信息。使用描述性统计来描述这些特征。结果显示,约40%的咨询对象具有高教育水平,89%是荷兰本地人。与荷兰总体人群相比,我们发现教育水平(p = < 0.01)和移民身份(p = < 0.001)存在显著差异。这表明癌症遗传咨询存在差异,进而导致弱势群体获得的医疗服务不够理想。健康素养有限可能会给教育程度较低或有移民背景的咨询对象的癌症遗传咨询带来特别的挑战。我们的研究指出,在将弱势群体患者转介至癌症遗传咨询方面有很大的改进空间。

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