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设想在乳腺癌筛查项目中实施个性化方法:利益相关者的观点。

Envisioning Implementation of a Personalized Approach in Breast Cancer Screening Programs: Stakeholder Perspectives.

作者信息

Esquivel-Sada Daphne, Lévesque Emmanuelle, Hagan Julie, Knoppers Bartha Maria, Simard Jacques

机构信息

Sociologist, Centre of Genomics and Policy, Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, QC.

Lawyer and Academic Associate, Centre of Genomics and Policy, Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, QC.

出版信息

Healthc Policy. 2019 Nov;15(2):39-54. doi: 10.12927/hcpol.2019.26072.

Abstract

BACKGROUND

Advances in genomics and epidemiology can foster the implementation of a risk-based approach to current age-based breast cancer screening programs. This personalized approach would challenge the trajectory for women in the healthcare system by adding both a risk-assessment step (including a genomic test) and screening options.

OBJECTIVE

The aim of this study is to explore, from an organizational perspective, the acceptability of different proposals for each step of the trajectory for women in the healthcare system should a personalized approach be implemented in the province of Quebec.

METHODS

We interviewed 20 professional stakeholders who are either involved in the current breast cancer screening program in Quebec or who are likely to play a role in the future implementation of a personalized risk-based approach.

RESULTS|DISCUSSION: Preferences are split between proposals supporting self-management by the women themselves (e.g., solicitation through media campaign, self-collection of information and sample and results provided by letter) and proposals prioritizing more interaction between women and healthcare providers (e.g., solicitation by health professionals, collection of information and samples by a nurse and results provided by health professionals).

摘要

背景

基因组学和流行病学的进展有助于在当前基于年龄的乳腺癌筛查项目中实施基于风险的方法。这种个性化方法将通过增加风险评估步骤(包括基因检测)和筛查选项,对医疗保健系统中女性的就医流程提出挑战。

目的

本研究的目的是从组织角度探讨,若在魁北克省实施个性化方法,医疗保健系统中女性就医流程各步骤的不同提议的可接受性。

方法

我们采访了20名专业利益相关者,他们要么参与了魁北克当前的乳腺癌筛查项目,要么可能在未来基于风险的个性化方法实施中发挥作用。

结果|讨论:在支持女性自我管理的提议(例如通过媒体宣传进行招募、自我收集信息以及通过信件提供样本和结果)和优先考虑女性与医疗保健提供者之间更多互动的提议(例如由医疗专业人员进行招募、由护士收集信息和样本以及由医疗专业人员提供结果)之间,存在不同偏好。

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