Infectious Disease Epidemiology, Prevention and Control Division, Minnesota Department of Health, Saint Paul, MN, USA.
Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA.
Genet Med. 2019 Nov;21(11):2468-2477. doi: 10.1038/s41436-019-0517-y. Epub 2019 Apr 17.
This study examined whether participants who learned research results related to a germline CDKN2A variant known to be associated with increased risk of pancreatic cancer and malignant melanoma would pursue confirmatory testing and cancer screening, share the genetic information with health care providers and family, and change risk perceptions.
Participants were pancreas research registry enrollees whose biological sample was tested in a research laboratory for the variant. In total, 133 individuals were invited to learn a genetic research result and participate in a study about the disclosure process. Perceived cancer risk, screening intentions, and behaviors were assessed predisclosure, immediately postdisclosure, and six months postdisclosure.
Eighty individuals agreed to participate and 63 completed the study. Immediately postdisclosure, carriers reported greater intentions to undergo pancreatic cancer and melanoma screening (p values ≤0.024). Seventy-three percent of carriers (47.5% noncarriers) intended to seek confirmatory testing within six months and 20% (2.5% noncarriers) followed through. All participants shared results with ≥1 family member. More carriers shared results with their health care provider than noncarriers (p = 0.028).
Recipients of cancer genetic research results may not follow through with recommended behaviors (confirmatory testing, screening), despite stated intentions. The research result disclosure motivated follow-up behaviors among carriers more than noncarriers.
本研究旨在探讨参与者在得知与胰腺癌和恶性黑色素瘤风险增加相关的种系 CDKN2A 变异体的研究结果后,是否会进行确认性检测和癌症筛查,是否会与医疗服务提供者和家人分享遗传信息,以及是否会改变风险认知。
参与者为胰腺研究登记处的注册者,其生物样本在研究实验室中接受了该变异体的检测。共有 133 人受邀了解遗传研究结果,并参与一项关于披露过程的研究。在披露前、披露后即刻和披露后六个月评估了感知的癌症风险、筛查意向和行为。
80 人同意参与,63 人完成了研究。披露后即刻,携带者报告了更大的接受胰腺癌和黑色素瘤筛查的意向(p 值≤0.024)。73%的携带者(47.5%的非携带者)打算在六个月内寻求确认性检测,20%(2.5%的非携带者)跟进。所有参与者均与≥1 名家庭成员分享了结果。与非携带者相比,更多的携带者与医疗服务提供者分享了结果(p=0.028)。
尽管参与者表达了意图,但他们可能不会遵循癌症遗传研究结果的推荐行为(确认性检测、筛查)。研究结果的披露促使携带者比非携带者采取了更多的后续行为。