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遗传性癌症患者风险管理的获益与负担:以 Li-Fraumeni 综合征为例。

Benefits and burdens of risk management for young people with inherited cancer: A focus on Li-Fraumeni syndrome.

机构信息

BMEDS (Hons), PhD, Postdoctoral Researcher, Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Parkville, Vic; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Vic.

PhD, Professor of Health Sociology, Melbourne School of Population and Global Health, University of Melbourne, Vic.

出版信息

Aust J Gen Pract. 2021 Aug;50(8):538-544. doi: 10.31128/AJGP-04-21-5954.

Abstract

BACKGROUND AND OBJECTIVES

Discussing population-based cancer risk and screening is common in general practice. Patients with an inherited cancer syndrome, however, may need more nuanced discussions. Li-Fraumeni syndrome (LFS) is a rare, inherited cancer syndrome that affects many organ systems from birth and requires intensive, whole-body cancer risk management. The aim of this study was to explore the risk management experiences of young people (aged 15-39 years) with, or at risk of, LFS.

METHOD

Using an interpretive description design, semi-structured interviews were conducted with young people diagnosed with, or at risk of, LFS from across Australia. Interview transcripts were analysed with team-based, codebook thematic analysis.

RESULTS

Thirty young people (mean age 25.5 years) participated. Participants described intensive screening and risk-reducing mastectomy (for women) as their 'best shot' to control their cancer risks with LFS. Engaging in these options as a young person came with a slew of psychosocial implications.

DISCUSSION

General practitioners may help to improve care for young people with inherited cancer syndromes by acknowledging the benefits and complex burdens of their risk management.

摘要

背景与目的

在普通实践中,讨论基于人群的癌症风险和筛查是很常见的。然而,患有遗传性癌症综合征的患者可能需要更细致的讨论。李-佛美尼综合征(Li-Fraumeni syndrome,LFS)是一种罕见的遗传性癌症综合征,从出生起就会影响许多器官系统,需要进行强化的全身癌症风险管理。本研究旨在探讨患有或有患 LFS 风险的年轻人(15-39 岁)的风险管理经验。

方法

采用解释性描述设计,对来自澳大利亚各地的确诊或有患 LFS 风险的年轻人进行了半结构化访谈。使用团队为基础的代码本主题分析方法对访谈记录进行了分析。

结果

共有 30 名年轻人(平均年龄 25.5 岁)参与了研究。参与者描述了强化筛查和预防性乳房切除术(针对女性)是他们控制 LFS 癌症风险的“最佳选择”。作为年轻人参与这些选择会带来一系列心理社会影响。

讨论

普通医生可以通过承认遗传性癌症综合征患者的风险管理的益处和复杂负担,来改善对这些年轻人的护理。

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