Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA.
Department of Communication Studies, Franklin College of Arts and Sciences, University of Georgia, Athens, USA.
Sci Rep. 2019 Jul 3;9(1):9599. doi: 10.1038/s41598-019-45967-6.
This study aimed to assess women's willingness to alter mammogram frequency based on their low risk for HBOC, and to examine if cognitive and emotional factors are associated with women's inclination to decrease mammogram frequency. We conducted an online survey with women (N = 124) who were unlikely to have a BRCA mutation and at average population risk for breast cancer based on family history. Most women were either white (50%) or African American (38%) and were 50 years or older (74%). One-third of women (32%) were willing to decrease mammogram frequency (as consistent with the USPSTF guideline), 42% reported being unwilling and 26% were unsure. Multivariate logistic regression showed that feeling worried about breast cancer (Adjust OR = 0.33, p = 0.01), greater genetic risk knowledge (Adjust OR = 0.74, p = 0.047), and more frequent past mammogram screening (Adjust OR = 0.13, p = 0.001) were associated with being less willing to decrease screening frequency. Findings suggest that emerging genomics-informed medical guidelines may not be accepted by many patients when the recommendations go against what is considered standard practice. Further study of the interplay between emotion- and cognition-based processing of the HBOC screen result will be important for strategizing communication interventions aimed at realizing the potential of precision public health.
本研究旨在评估女性根据其低 HBOC 风险改变乳房 X 光检查频率的意愿，并研究认知和情绪因素是否与女性减少乳房 X 光检查频率的倾向相关。我们对不太可能携带 BRCA 突变且基于家族史的乳腺癌平均人群风险的女性（N=124）进行了在线调查。大多数女性是白人（50%）或非裔美国人（38%），年龄在 50 岁或以上（74%）。三分之一的女性（32%）愿意降低乳房 X 光检查的频率（与 USPSTF 指南一致），42%的女性表示不愿意，26%的女性不确定。多变量逻辑回归显示，担心乳腺癌（调整后的优势比 = 0.33，p = 0.01）、更多的遗传风险知识（调整后的优势比 = 0.74，p = 0.047）和更频繁的过去乳房 X 光检查筛查（调整后的优势比 = 0.13，p = 0.001）与减少筛查频率的意愿降低有关。研究结果表明，当建议与标准做法相悖时，新兴的基于基因组学的医学指南可能不会被许多患者接受。进一步研究基于情绪和认知的 HBOC 筛查结果的相互作用对于制定旨在实现精准公共卫生潜力的沟通干预策略非常重要。
