Institut Curie, Supportive Care Department, Psycho-oncology Unit, PSL University, 26 rue d'Ulm, Paris, 75005 Paris Cedex 05, France; University of Paris, 71 Avenue Edouard Vaillant, Boulogne-Billancourt, 92774, France.
Institut Curie, Cancer Genetic Clinic, PSL University, 26 rue d'Ulm, 75005 Paris Cedex 05, France.
Breast. 2021 Dec;60:38-44. doi: 10.1016/j.breast.2021.08.011. Epub 2021 Aug 23.
OBJECTIVES: Comprehensive breast cancer (BC) risk models integrating effects of genetic (GRF) and non-genetic risk factors (NGRF) may refine BC prevention recommendations. We explored the perceived information received on BC risk factors, and related characteristics, in female relatives of women with a BRCA1/2 or PALB2 pathogenic variant, undergoing BC risk assessment using the CanRisk© prediction tool. METHODS: Of 200 consecutive cancer-free women approached after the initial genetic consultation, 161 (80.5%) filled in questionnaires on their perception of information received and wished further information on BC risk factors (e.g., being a carrier of a moderate risk altered gene, personal genetic profile, lifestyles). Multilevel multivariate linear models were performed accounting for the clinician who met the counselee and exploring the effect of counselees' socio-demographic, familial and psychological characteristics on the perceived extent of information received. RESULTS: Perceived no/little information received and wish for further information were more frequent for NGRF (>50%) than for GRF, especially high-risk genes (<20%). Perceived amount of information received and desire for further information were inversely correlated (p=<0.0001). Higher education level related to lower perceived levels of information received on GRF. Younger counselees' age (β = 0.13, p = 0.02) and less frequent engagement coping (e.g., inclination to solicit information) (β = 0.24, p = 0.02) related to lower perceived information received about NGRF. Other assessed counselees' features were not found to be associated to GRF and NGRF information perception. CONCLUSIONS: Awareness of counselees' perceived lack of information on BC risk factors indicates a need to enhance evidence-based information on BC NGRF especially.
目的:综合考虑遗传(GRF)和非遗传风险因素(NGRF)对乳腺癌(BC)风险的影响的全面 BC 风险模型可能会完善 BC 预防建议。我们探讨了接受 BRCA1/2 或 PALB2 致病性变异的女性的女性亲属在使用 CanRisk©预测工具进行 BC 风险评估时,对 BC 风险因素及其相关特征的感知信息。
方法:在最初的遗传咨询后,对 200 名连续的无癌症女性进行了调查,其中 161 名(80.5%)填写了关于其对所接受信息的感知以及对 BC 风险因素(例如,携带中度风险改变基因、个人基因谱、生活方式)的进一步信息的问卷。采用多水平多变量线性模型,考虑到与被咨询者会面的临床医生,并探讨了被咨询者的社会人口统计学、家族和心理特征对感知信息接收程度的影响。
结果:与 GRF 相比,NGRF(>50%)的感知信息较少或几乎没有,希望获得更多信息,特别是高风险基因(<20%)。感知信息的数量与进一步信息的愿望呈负相关(p<0.0001)。较高的教育水平与 GRF 相关的感知信息量较低有关。被咨询者的年龄越小(β=0.13,p=0.02)和应对方式(例如寻求信息的倾向)越不频繁(β=0.24,p=0.02)与 NGRF 相关的感知信息量较低有关。评估的其他被咨询者特征与 GRF 和 NGRF 信息感知无关。
结论:意识到被咨询者对 BC 风险因素的感知缺乏信息表明需要加强对 BC NGRF 的循证信息。
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