Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Virginia, Charlottesville, Virginia, USA.
Kaiser San Francisco, 2238 Geary Blvd, San Francisco, CA, 94114, 415-833-4199, USA.
J Obstet Gynaecol Res. 2020 Sep;46(9):1835-1841. doi: 10.1111/jog.14366. Epub 2020 Jul 12.
Precancer identification of women with hereditary breast and ovarian cancer (HBOC) could prevent 20% of these ovarian cancers. The objective was to determine whether standardized Facing Our Risk of Cancer Empowered (FORCE) materials are acceptable, improve knowledge of HBOC and increase disclosure to family members.
A prospective cohort of women with breast or ovarian cancer was identified prior to genetic testing. Subjects completed a baseline knowledge survey and were provided three communication aids. Knowledge, acceptability and communication to family members were reassessed at 6 months and compared to a retrospective cohort who had undergone genetic testing for breast or ovarian cancer prior to the intervention. The primary outcome was increase in HBOC knowledge, requiring 20 pre- and postknowledge scores to detect a 10% difference.
Forty women were enrolled. The median age at cancer diagnosis was 50 years and 55% had a family history of breast or ovarian cancer. Though subjects found the resources acceptable, knowledge scores did not improve after their use. Disclosure rates were of no different between cohorts (83% preintervention vs 77% postintervention, P = 0.26) though there was an increase in deleterious mutation carriers, 0% (0/6) preintervention vs 100% (22/22) postintervention. Rates of subsequent testing in relatives were low in both preintervention and postintervention cohorts (0% vs 4.5%).
Inclusion of standardized communication tools is acceptable to patients. Knowledge did not improve after their use. In deleterious mutation carriers, disclosure rates increased postintervention.
对遗传性乳腺癌和卵巢癌（HBOC）女性进行癌前识别可预防 20%的卵巢癌。本研究旨在确定标准化的“直面癌症风险增强版（FORCE）”材料是否可以被接受，能否提高对 HBOC 的认识并增加对家庭成员的披露。
在进行基因检测之前，确定了患有乳腺癌或卵巢癌的前瞻性队列。研究对象完成了基线知识调查，并提供了三种沟通辅助工具。在 6 个月时重新评估了知识、可接受性和与家庭成员的沟通情况，并与接受过乳腺癌或卵巢癌基因检测的回顾性队列进行了比较。主要结局是增加 HBOC 知识，需要 20 个预和后知识评分来检测 10%的差异。
共纳入 40 名女性。癌症诊断时的中位年龄为 50 岁，55%有乳腺癌或卵巢癌家族史。尽管研究对象认为这些资源是可以接受的，但使用后知识评分并没有提高。两个队列的披露率没有差异（干预前为 83%，干预后为 77%，P=0.26），但有害突变携带者的比例有所增加，干预前为 0%（0/6），干预后为 100%（22/22）。两个队列的亲属后续检测率均较低（干预前为 0%，干预后为 4.5%）。
纳入标准化沟通工具可被患者接受。使用后知识没有提高。在有害突变携带者中，干预后披露率增加。
