Allen Caitlin G, Escoffery Cam, Haardörfer Regine, McBride Colleen M
Emory University, Rollins School of Public Health, Atlanta, Georgia, USA,
Emory University, Rollins School of Public Health, Atlanta, Georgia, USA.
Public Health Genomics. 2018;21(3-4):144-153. doi: 10.1159/000499125. Epub 2019 Apr 9.
Public willingness to collect personal family health history (FHH) assessments is integral to implement population screening to identify those at high cancer risk who could benefit most from lifesaving interventions. Yet, surprisingly little consideration has been given to factors associated with the public's perceived importance of FHH in the context of cancer.
Using data from the 2013 Health Information National Trends survey, we assessed the association of intrapersonal (e.g., cancer worry), sociodemographic (e.g., education), and interpersonal-level factors (e.g., family trust) associated with not perceiving FHH assessment to be very important for personal health. Associations were tested with bivariate analyses and hierarchical logistic regression.
Of the 3,007 respondents, 32.7% reported perceiving FHH as not very important to their health. Whites (p < 0.001), males (p = 0.003), and those born in the United States (p = 0.004) were most likely to perceive FHH as not very important. Those who were least worried about cancer and perceived that cancer risk could not be lowered also viewed FHH as not very important (p = 0.002, p = 0.018, respectively). In hierarchical regression analyses, the association of low cancer worry remained significant after accounting for sociodemographic and interpersonal factors. The addition of sociodemographic factors modestly improved the model; the addition of interpersonal factors did not improve the model.
A sizable proportion of the public does not perceive FHH to be very important, may be hard to reach, and impede implementation of population screening guidelines for inherited cancers. Campaigns to increase the perceived value of FHH assessment may need to be tailored to demographic subgroups, emphasize cancer prevention, and encourage family communication.
公众收集个人家族健康史(FHH)评估的意愿对于实施人群筛查至关重要,通过筛查可识别出那些患癌风险高且能从挽救生命的干预措施中获益最大的人群。然而,令人惊讶的是,在癌症背景下,与公众对FHH重要性认知相关的因素却很少得到考虑。
利用2013年健康信息国家趋势调查的数据,我们评估了与认为FHH评估对个人健康不太重要相关的个人因素(如癌症担忧)、社会人口学因素(如教育程度)和人际层面因素(如家庭信任)。通过双变量分析和分层逻辑回归对关联进行了检验。
在3007名受访者中,32.7%的人表示认为FHH对他们的健康不太重要。白人(p<0.001)、男性(p = 0.003)以及在美国出生的人(p = 0.004)最有可能认为FHH不太重要。那些对癌症最不担心且认为癌症风险无法降低的人也认为FHH不太重要(分别为p = 0.002,p = 0.018)。在分层回归分析中,在考虑了社会人口学和人际因素后,低癌症担忧的关联仍然显著。社会人口学因素的加入适度改善了模型;人际因素的加入并未改善模型。
相当一部分公众认为FHH不太重要,可能难以触及,这阻碍了遗传性癌症人群筛查指南的实施。提高FHH评估认知价值的宣传活动可能需要针对不同人口亚组进行定制,强调癌症预防,并鼓励家庭沟通。