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女性家庭成员对先证者所分享的BRCA1/2基因检测结果不确定为阴性缺乏理解。

Female family members lack understanding of indeterminate negative BRCA1/2 test results shared by probands.

作者信息

Himes Deborah O, Gibbons Deborah K, Birmingham Wendy C, Beckstrand Renea L, Gammon Amanda, Kinney Anita Y, Clayton Margaret F

机构信息

College of Nursing, Brigham Young University, Provo, Utah.

Department of Psychology, Brigham Young University, Provo, Utah.

出版信息

J Genet Couns. 2019 Oct;28(5):950-961. doi: 10.1002/jgc4.1147. Epub 2019 Jun 14.

Abstract

Genetic test results have important implications for close family members. Indeterminate negative results are the most common outcome of BRCA1/2 mutation testing. Little is known about family members' understanding of indeterminate negative BRCA1/2 test results. The purpose of this mixed-methods study was to investigate how daughters and sisters received and understood genetic test results as shared by their mothers or sisters. Participants included 81 women aged 40-74 with mothers or sisters previously diagnosed with breast cancer and who received indeterminate negative BRCA1/2 test results. Participants had never been diagnosed with breast cancer nor received their own genetic testing or counseling. This Institutional Review Board-approved study utilized semi-structured interviews and surveys. Descriptive coding with theme development was used during qualitative analysis. Participants reported low amounts of information shared with them. Most women described test results as negative and incorrectly interpreted the test to mean there was no genetic component to the pattern of cancer in their families. Only seven of 81 women accurately described test results consistent with the meaning of an indeterminate negative. Our findings demonstrate that indeterminate negative genetic test results are not well understood by family members. Lack of understanding may lead to an inability to effectively communicate results to primary care providers and missed opportunities for prevention, screening, and further genetic testing. Future research should evaluate acceptability and feasibility of providing family members letters they can share with their own primary care providers.

摘要

基因检测结果对近亲具有重要意义。不确定的阴性结果是BRCA1/2基因突变检测最常见的结果。关于家庭成员对不确定的BRCA1/2检测阴性结果的理解知之甚少。这项混合方法研究的目的是调查女儿和姐妹如何接收和理解她们的母亲或姐妹分享的基因检测结果。参与者包括81名年龄在40 - 74岁之间的女性,她们的母亲或姐妹此前被诊断患有乳腺癌,且她们收到了不确定的BRCA1/2检测阴性结果。参与者从未被诊断患有乳腺癌,也未接受过自己的基因检测或咨询。这项经机构审查委员会批准的研究采用了半结构化访谈和调查。定性分析过程中使用了带有主题发展的描述性编码。参与者报告称与他们分享的信息很少。大多数女性将检测结果描述为阴性,并错误地将检测结果解读为她们家族中的癌症模式不存在遗传因素。81名女性中只有7人准确描述了与不确定阴性结果含义相符的检测结果。我们的研究结果表明,家庭成员对不确定的基因检测阴性结果理解不足。理解不足可能导致无法有效地将结果传达给初级保健提供者,以及错过预防、筛查和进一步基因检测的机会。未来的研究应该评估为家庭成员提供可与自己的初级保健提供者分享的信件的可接受性和可行性。

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