Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
Division of Public Health Sciences, Washington University in St. Louis, St. Louis, MO, USA.
Transl Behav Med. 2018 Jan 29;8(1):71-79. doi: 10.1093/tbm/ibx042.
The growing importance of genome sequencing means that patients will increasingly face decisions regarding what results they would like to learn. The present study examined psychological and clinical factors that might affect these preferences. 1,080 women diagnosed with breast cancer at age 40 or younger completed an online survey. We assessed their interest in learning various types of genome sequencing results: risk of preventable disease or unpreventable disease, cancer treatment response, uncertain meaning, risk to relatives' health, and ancestry/physical traits. Multivariable logistic regression was used to examine whether being "very" interested in each result type was associated with clinical factors: BRCA1/2 mutation status, prior genetic testing, family history of breast cancer, and psychological factors: cancer recurrence worry, genetic risk worry, future orientation, health information orientation, and genome sequencing knowledge. The proportion of respondents who were very interested in learning each type of result ranged from 16% to 77%. In all multivariable models, those who were very interested in learning a result type had significantly higher knowledge about sequencing benefits, greater genetic risks worry, and stronger health information orientation compared to those with less interest (p-values < .05). Our findings indicate that high interest in return of various types of genome sequencing results was more closely related to psychological factors. Shared decision-making approaches that increase knowledge about genome sequencing and incorporate patient preferences for health information and learning about genetic risks may help support patients' informed choices about learning different types of sequencing results.
基因组测序的重要性日益增加,这意味着患者将越来越多地面临他们希望了解哪些结果的决策。本研究探讨了可能影响这些偏好的心理和临床因素。1080 名 40 岁或更年轻被诊断患有乳腺癌的女性完成了一项在线调查。我们评估了她们对学习各种类型的基因组测序结果的兴趣:预防疾病或不可预防疾病的风险、癌症治疗反应、不确定意义、对亲属健康的风险以及遗传/身体特征。多变量逻辑回归用于检查对每种结果类型的“非常”感兴趣是否与临床因素有关:BRCA1/2 基因突变状态、先前的基因检测、乳腺癌家族史以及心理因素:癌症复发担忧、遗传风险担忧、未来取向、健康信息取向和基因组测序知识。对每种结果类型非常感兴趣的受访者比例从 16%到 77%不等。在所有多变量模型中,与不太感兴趣的人相比,对学习某种结果类型非常感兴趣的人对测序益处的了解程度更高,对遗传风险的担忧程度更高,对健康信息的关注程度更强(p 值<.05)。我们的研究结果表明,对各种类型的基因组测序结果回报的高度兴趣与心理因素更为密切相关。增加对基因组测序的了解并纳入患者对健康信息和遗传风险了解的偏好的共同决策方法可能有助于支持患者对学习不同类型测序结果的知情选择。