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菲律宾乳腺癌高危女性的风险认知与筛查行为:对癌症遗传咨询的启示

Risk perception and screening behavior of Filipino women at risk for breast cancer: implications for cancer genetic counseling.

作者信息

Lagarde John Benedict B, Laurino Mercy Y, San Juan Michael D, Cauyan Jaclyn Marie L, Tumulak Ma-Am Joy R, Ventura Elizabeth R

机构信息

Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.

Cancer Prevention Programs, Seattle Cancer Care Alliance, Seattle, WA, USA.

出版信息

J Community Genet. 2019 Apr;10(2):281-289. doi: 10.1007/s12687-018-0391-3. Epub 2018 Sep 27.

Abstract

The burden and experiences that come with a breast cancer diagnosis in a family impact how women perceive personal cancer risk and pursue preventive strategies and/or early detection screening. Hence, this study sought to understand how Filipino women incorporate their experiences living with a sister diagnosed with early-onset breast cancer to their personal perceived risk and screening behavior. Guided by phenomenological approach of inquiry, a face-to-face, semi-structured interview was conducted with 12 purposively sampled women with a female sibling diagnosed with breast cancer before age 50. Transcripts were analyzed using thematic analysis. Results revealed that the respondents tend to compare themselves with their sister when constructing views of personal cancer vulnerability. The subjective risk is also shaped by their beliefs regarding cancer causation such as personalistic causes, personal theory of inheritance, and locus of control. Their sisters' cancer diagnoses serve as a motivation for them to perform breast self-examination. However, clinical breast examination and screening mammography are underutilized due to perceived barriers such as difficulty allotting time to medical consultation, fear, and lack of finances. Overall, cancer risk perception and screening behavior are important factors that must be addressed during cancer genetic counseling consultations. Better understanding of these factors will aid in the formulation of an effective management plan for at-risk women.

摘要

家族中乳腺癌诊断所带来的负担和经历,会影响女性对个人患癌风险的认知以及采取预防策略和/或早期检测筛查的行为。因此,本研究旨在了解菲律宾女性如何将与被诊断为早发性乳腺癌的姐妹共同生活的经历融入到她们个人感知的风险和筛查行为中。以现象学探究方法为指导,对12名经过目的性抽样的女性进行了面对面的半结构化访谈,这些女性都有一个在50岁之前被诊断出患有乳腺癌的姐妹。使用主题分析法对访谈记录进行了分析。结果显示,在构建个人癌症易感性观点时,受访者倾向于将自己与姐妹进行比较。主观风险也受到她们对癌症病因的信念影响,如个人主义病因、个人遗传理论和控制点。姐妹的癌症诊断成为她们进行乳房自我检查的动力。然而,由于存在诸如难以抽出时间进行医疗咨询、恐惧和缺乏资金等感知到的障碍,临床乳房检查和乳腺筛查的使用率较低。总体而言,癌症风险认知和筛查行为是癌症遗传咨询过程中必须解决的重要因素。对这些因素的更好理解将有助于为高危女性制定有效的管理计划。

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