为女性提供个性化的 10 年乳腺癌风险评估对其心理的影响。
Psychological impact of providing women with personalised 10-year breast cancer risk estimates.
机构信息
Manchester Centre of Health Psychology, School of Health Sciences, University of Manchester, Manchester, M13 9PL, UK.
Prevent Breast Cancer Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester, Manchester, M23 9LT, UK.
出版信息
Br J Cancer. 2018 Jun;118(12):1648-1657. doi: 10.1038/s41416-018-0069-y. Epub 2018 May 8.
BACKGROUND
The Predicting Risk of Cancer at Screening (PROCAS) study estimated 10-year breast cancer risk for 53,596 women attending NHS Breast Screening Programme. The present study, nested within the PROCAS study, aimed to assess the psychological impact of receiving breast cancer risk estimates, based on: (a) the Tyrer-Cuzick (T-C) algorithm including breast density or (b) T-C including breast density plus single-nucleotide polymorphisms (SNPs), versus (c) comparison women awaiting results.
METHODS
A sample of 2138 women from the PROCAS study was stratified by testing groups: T-C only, T-C(+SNPs) and comparison women; and by 10-year risk estimates received: 'moderate' (5-7.99%), 'average' (2-4.99%) or 'below average' (<1.99%) risk. Postal questionnaires were returned by 765 (36%) women.
RESULTS
Overall state anxiety and cancer worry were low, and similar for women in T-C only and T-C(+SNPs) groups. Women in both T-C only and T-C(+SNPs) groups showed lower-state anxiety but slightly higher cancer worry than comparison women awaiting results. Risk information had no consistent effects on intentions to change behaviour. Most women were satisfied with information provided. There was considerable variation in understanding.
CONCLUSIONS
No major harms of providing women with 10-year breast cancer risk estimates were detected. Research to establish the feasibility of risk-stratified breast screening is warranted.
背景
在预测筛查癌症风险（PROCAS）研究中，对参加国民保健制度乳房筛查计划的 53596 名妇女进行了 10 年乳腺癌风险预测。本研究是 PROCAS 研究的一个嵌套研究，旨在根据以下两种方法评估接受乳腺癌风险估计值的心理影响：（a）包括乳腺密度的 Tyrer-Cuzick（T-C）算法或（b）包括乳腺密度和单核苷酸多态性（SNP）的 T-C，与（c）比较等待结果的女性。
方法
从 PROCAS 研究中抽取 2138 名妇女，按检测组分层：仅 T-C、T-C（+SNP）和比较组；并根据 10 年风险估计值分为：“中度”（5-7.99%）、“平均”（2-4.99%）或“低于平均”（<1.99%）风险。通过邮寄问卷的方式对 765 名（36%）妇女进行了随访。
结果
总体而言，状态焦虑和癌症担忧程度较低，且仅接受 T-C 和 T-C（+SNP）的妇女之间相似。仅接受 T-C 和 T-C（+SNP）的两组妇女的状态焦虑程度较低，但比等待结果的比较组妇女的癌症担忧程度略高。风险信息对改变行为的意愿没有一致的影响。大多数妇女对提供的信息感到满意。理解方面存在很大差异。
结论
未发现提供女性 10 年乳腺癌风险估计值的主要危害。有必要开展研究以确定风险分层乳房筛查的可行性。
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