风险态度与防晒行为：使用黑素瘤基因组风险干预措施能否改变行为？

Risk attitudes and sun protection behaviour: Can behaviour be altered by using a melanoma genomic risk intervention?

机构信息

NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Australia; Melanoma Institute Australia, The University of Sydney, Australia.

NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Australia.

出版信息

Cancer Epidemiol. 2019 Aug;61:8-13. doi: 10.1016/j.canep.2019.05.002. Epub 2019 May 15.

DOI:10.1016/j.canep.2019.05.002

PMID:31102918

Abstract

BACKGROUND

Exposure to ultraviolet radiation from sunlight is directly associated with melanoma skin cancer, however reducing sun-exposure can be difficult to achieve at a population level.

METHODS

Using a genomic risk information behaviour change trial for melanoma prevention, we classified participants as risk-seeking, risk-neutral or risk-averse for domain-specific risk taking (DOSPERT). One-way ANOVA determined the association between socio-demographic characteristics and risk-taking score, and multivariable linear regression ascertained impact of an individual's underlying risk propensity on an objective measure of sun-exposure, standard erythemal dose (SED), at 3-months follow-up.

RESULTS

Of 119 participants, mean age 53 years; 50% males, 87% had a personal/family history of cancer; 19% were classified risk-seeking, 57% risk-neutral. The mean risk-taking score was significantly higher in younger participants (≤50 years: 13.86 vs. >50 years: 11.11, p = 0.003); and lower in those with a personal/family history of skin cancer versus without (10.55 vs 13.33, p = 0.009). Risk averse individuals had lower weekly mean SEDs at 3-months than risk neutral and risk seeking individuals (2.56, 5.81, 4.81 respectively, p = 0.01). Risk seekers showed fewer sun protective habits (p < 0.001); and higher intentional tanning, (p = 0.01). At 3-months, risk seekers attained 16%-54% lower SEDs in the genomic information group compared with controls, however this was not significantly different across risk groups (interaction p = 0.13).

CONCLUSION

An individual's underlying risk attitude is likely associated with sun-exposure behaviours, and may modify the effect of a genomic risk information behaviour change intervention. Young people and risk seekers may benefit most from being given information on their genetic risk of melanoma.

摘要

背景

暴露于阳光中的紫外线辐射与皮肤黑色素瘤直接相关，然而减少阳光暴露对于整个人群来说可能难以实现。

方法

我们使用黑色素瘤预防的基因组风险信息行为改变试验，将参与者分为特定领域风险承担（DOSPERT）的风险寻求者、风险中性者或风险规避者。单因素方差分析确定了社会人口统计学特征与风险承担评分之间的关联，多变量线性回归确定了个体潜在风险倾向对 3 个月随访时阳光暴露的客观测量标准红斑剂量（SED）的影响。

结果

在 119 名参与者中，平均年龄为 53 岁；50%为男性，87%有个人/家族癌症史；19%被归类为风险寻求者，57%为风险中性者。年轻参与者的风险承担评分显著更高（≤50 岁：13.86 岁；>50 岁：11.11 岁，p=0.003）；有个人/家族皮肤癌史的参与者风险评分更低（10.55 岁；13.33 岁，p=0.009）。风险规避者在 3 个月时的每周平均 SED 低于风险中性和风险寻求者（分别为 2.56、5.81、4.81，p=0.01）。风险寻求者的防晒习惯更少（p<0.001）；且更倾向于有意晒黑（p=0.01）。在 3 个月时，与对照组相比，接受基因组信息组干预的风险寻求者的 SED 降低了 16%-54%，但风险组之间没有显著差异（交互作用 p=0.13）。