National Human Genome Research Institute, Bethesda, MD, United States of America; University of Technology Sydney, NSW, Australia.
National Cancer Institute, Rockville, MD, United States of America.
Prev Med. 2019 Jun;123:12-19. doi: 10.1016/j.ypmed.2019.02.027. Epub 2019 Feb 25.
We examined what proportion of the U.S. population with no personal cancer history reported receiving either genetic counseling or genetic testing for cancer risk, and also the association of these behaviors with cancer risk perceptions. We used data from the 2015 National Health Interview Survey. Objective relative risk scores for breast (women) and colorectal (men and women) cancer risk were generated for individuals without a personal history of cancer. Participants' risk perceptions were compared with their objective relative risk. Of 12,631 women, 1.2% reported receiving genetic counseling and 0.8% genetic testing for hereditary breast cancer risk. Of 15,085 men and women, 0.8% reported receiving genetic counseling and 0.3% genetic testing for hereditary colorectal cancer risk. Higher breast cancer risk perception was associated with genetic counseling (OR: 4.31, 95%CI: 2.56, 7.26) and testing (OR: 3.56, 95%CI: 1.80, 7.03). Similarly, higher perception of colorectal cancer risk was associated with genetic counseling (OR: 5.04, 95%CI: 2.57, 9.89) and testing (OR: 5.92, 95%CI: 2.40, 14.63). A higher proportion of individuals with colorectal cancer risk perceptions concordant with their objective risk (vs. discordant) had undergone genetic counseling or testing for colorectal cancer risk. Concordant risk perceptions for breast cancer were not associated with breast cancer genetic counseling or testing. Given frequent dialogue about implementing population level programs involving genetic services for cancer risk, policy makers and investigators should consider the role of risk perceptions in the effectiveness and design of such programs and potential strategies for addressing inaccuracies in risk perceptions.
我们研究了没有个人癌症病史的美国人口中，有多少人接受了癌症风险的遗传咨询或基因检测，以及这些行为与癌症风险认知的关系。我们使用了 2015 年全国健康访谈调查的数据。为没有个人癌症史的个体生成了乳腺癌（女性）和结直肠癌（男性和女性）风险的客观相对风险评分。将参与者的风险认知与他们的客观相对风险进行比较。在 12631 名女性中，1.2%报告接受了遗传性乳腺癌风险的遗传咨询，0.8%接受了基因检测。在 15085 名男性和女性中，0.8%报告接受了遗传性结直肠癌风险的遗传咨询，0.3%接受了基因检测。更高的乳腺癌风险认知与遗传咨询（OR：4.31，95%CI：2.56，7.26）和检测（OR：3.56，95%CI：1.80，7.03）相关。同样，更高的结直肠癌风险认知与遗传咨询（OR：5.04，95%CI：2.57，9.89）和检测（OR：5.92，95%CI：2.40，14.63）相关。与客观风险不一致的个体中，有更高比例的人接受了结直肠癌风险的遗传咨询或检测。而与结直肠癌风险认知一致的个体，则与乳腺癌的遗传咨询或检测无关。鉴于经常讨论实施涉及癌症风险的遗传服务的人群水平计划，政策制定者和研究人员应考虑风险认知在这些计划的有效性和设计中的作用，以及解决风险认知不准确的潜在策略。
