Sekhon Subhjit, Massad L Stewart, Hagemann Andrea R, Dick Rebecca, Leon Andrea, Zamorano Abigail S, Thaker Premal H, McCourt Carolyn K, Mutch David G, Powell Matthew A, Kuroki Lindsay M
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Gynecol Oncol Rep. 2019 Aug 10;29:106-110. doi: 10.1016/j.gore.2019.07.013. eCollection 2019 Aug.
It is unclear if endometrial cancer (EC) patients are aware of their modifiable risk factors. We administered a 33-item questionnaire to EC patients at a university-based cancer center to assess their understanding of how comorbidities and lifestyle/sexual behaviors impact their cancer risk. We also inquired about their access to a primary care physician (PCP). Pearson's χ test or Fisher's exact test were used to assess differences in understanding based on a dichotomized Charlson comorbidity score, <7 vs ≥7. Of the 50 surveyed women (81% response rate), 39 reported hypertension (80%) and 36 (72%) diabetes. All had a PCP. Most were aware that obesity contributes to diabetes (43/48, 90%), hypertension (42/48, 88%), and heart attack (42, 88%), but only 19/49 (39%) knew that EC is more common in overweight/obese women. More than half lacked understanding of the following risks including modifiable risk factors-unhealthy diet (31, 62%), hormone replacement therapy (38, 76%), alcohol (30, 60%), and the protective effects of cigarette smoking (38, 76%). Most also incorrectly identified the following sexual health factors as risks for EC: early coitarche (30, 60%), or having an abortion (27, 54%), a sexually transmitted infection (35, 70%) or human immunodeficiency virus (34, 68%). Although EC patients recognize that obesity is linked to comorbidities, less than half are aware that it contributes to their cancer risk. Furthermore, responses to lifestyle/sexual health behaviors suggest women may lack understanding of global differences between endometrial and cervical cancer risk factors.
目前尚不清楚子宫内膜癌(EC)患者是否知晓其可改变的风险因素。我们在一家大学附属医院的癌症中心对EC患者进行了一项包含33个条目的问卷调查,以评估他们对合并症以及生活方式/性行为如何影响其癌症风险的理解。我们还询问了他们能否获得初级保健医生(PCP)的服务。采用Pearson卡方检验或Fisher精确检验,根据二分法的Charlson合并症评分(<7 vs≥7)评估理解上的差异。在50名接受调查的女性中(应答率81%),39人报告患有高血压(80%),36人(72%)患有糖尿病。所有人都有初级保健医生。大多数人意识到肥胖会导致糖尿病(43/48,90%)、高血压(42/48,88%)和心脏病发作(42,88%),但只有19/49(39%)的人知道EC在超重/肥胖女性中更为常见。超过一半的人对以下风险缺乏了解,包括可改变的风险因素——不健康饮食(31,62%)、激素替代疗法(38,76%)、酒精(30,60%)以及吸烟的保护作用(38,76%)。大多数人还错误地将以下性健康因素认定为EC的风险因素:初次性交过早(30,60%)、堕胎(27,54%)、性传播感染(35,70%)或人类免疫缺陷病毒(34,68%)。尽管EC患者认识到肥胖与合并症有关,但不到一半的人意识到肥胖会增加其患癌风险。此外,对生活方式/性健康行为的回答表明,女性可能对子宫内膜癌和宫颈癌风险因素之间的整体差异缺乏了解。