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结直肠癌幸存者对基因检测及使用非甾体抗炎药预防癌症复发的靶向治疗的接受度。

Colorectal Cancer Survivors' Receptivity toward Genomic Testing and Targeted Use of Non-Steroidal Anti-Inflammatory Drugs to Prevent Cancer Recurrence.

作者信息

O'Malley Denalee M, Blair Cindy K, Greenbaum Alissa, Wiggins Charles L, Rajput Ashwani, Chiu Vi K, Kinney Anita Y

机构信息

The State University of New Jersey, New Brunswick, NJ, USA.

Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.

出版信息

J Community Genet. 2022 Apr;13(2):201-214. doi: 10.1007/s12687-021-00574-9. Epub 2022 Jan 8.

Abstract

Genomic testing and targeted use of non-steroidal anti-inflammatory drugs (NSAIDs) may mitigate cancer recurrence risks. This study examines colorectal cancer (CRC) survivors' interest and receptivity to these strategies. Patients diagnosed with stage I-III CRC in 2004-2012 were recruited through the New Mexico Cancer Registry to complete a cancer survivorship experiences survey. We assessed interest in genomic testing, daily aspirin (ASA) and NSAID use, and receptivity to future daily ASA/NSAIDs. Descriptive statistics and multivariable logistic regression models estimated factors associated with genomic testing interest. Receptivity to future ASA/NSAIDs use was estimated for non-users of ASA/NSAIDs. Among CRC survivors (n = 273), 83% endorsed interest in genomic testing, 25% were ASA users and 47% ASA/NSAIDs users. In our final model, genomic testing interest was associated with being uncoupled [OR = 4.11; 95% CI = 1.49-11.35], low income [OR = 0.35, 95% CI: 0.14-0.88], smoking history [OR = 0.35, 95% CI: 0.14-0.90], low [OR: 0.33, 95% CI: 0.07-1.43] and moderate [OR: 0.26, 95% CI: 0.11-0.61] health literacy, and personal CRC risk worry [OR: 2.86, 95% CI: 1.63-5.02, p = 0.0002]. In our final model, ASA use was associated with age [OR: 1.05, 95% CI: 1.01-1.10] and cardiovascular disease history [OR: 2.42, 95% CI: 1.23-4.73, p = 0.010]. Among non-users ASA/NSAIDs, 83% reported receptivity to ASA/NSAIDs to reduce cancer risks, and no significant correlates were identified. The majority of survivors' expressed genomic testing interest and endorsed receptivity toward ASA/NSAIDs use for cancer risk management. Further research to optimize ASA/NSAIDs use guided by genomic testing is warranted.

摘要

基因组检测和非甾体抗炎药(NSAIDs)的靶向使用可能会降低癌症复发风险。本研究调查了结直肠癌(CRC)幸存者对这些策略的兴趣和接受度。通过新墨西哥癌症登记处招募了2004年至2012年被诊断为I-III期CRC的患者,以完成癌症幸存者经历调查。我们评估了对基因组检测、每日服用阿司匹林(ASA)和使用NSAIDs的兴趣,以及对未来每日服用ASA/NSAIDs的接受度。描述性统计和多变量逻辑回归模型估计了与基因组检测兴趣相关的因素。对未使用ASA/NSAIDs的患者估计了其对未来使用ASA/NSAIDs的接受度。在CRC幸存者(n = 273)中,83%表示对基因组检测感兴趣,25%是ASA使用者,47%是ASA/NSAIDs使用者。在我们的最终模型中,基因组检测兴趣与未婚[比值比(OR)= 4.11;95%置信区间(CI)= 1.49 - 11.35]、低收入[OR = 0.35,95% CI:0.14 - 0.88]、吸烟史[OR = 0.35,95% CI:0.14 - 0.90]、低[OR:0.33,95% CI:0.07 - 1.43]和中等[OR:0.26,95% CI:0.11 - 0.61]健康素养以及个人对CRC风险的担忧[OR:2.86,95% CI:1.63 - 5.02,p = 0.0002]相关。在我们的最终模型中,使用ASA与年龄[OR:1.05,95% CI:1.01 - 1.10]和心血管疾病史[OR:2.42,95% CI:1.23 - 4.73,p = 0.010]相关。在未使用ASA/NSAIDs的患者中,83%报告愿意使用ASA/NSAIDs来降低癌症风险,且未发现显著的相关因素。大多数幸存者表达了对基因组检测的兴趣,并认可接受使用ASA/NSAIDs进行癌症风险管理。有必要进行进一步研究,以优化在基因组检测指导下的ASA/NSAIDs使用。

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Fear of cancer recurrence in patients undergoing germline genome sequencing.对接受种系基因组测序的患者的癌症复发恐惧。
Support Care Cancer. 2021 Dec;29(12):7289-7297. doi: 10.1007/s00520-021-06311-9. Epub 2021 May 25.
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Chemoprevention of colorectal cancer: Past, present, and future.结直肠癌的化学预防:过去、现在和未来。
Cancer Sci. 2019 Oct;110(10):3018-3026. doi: 10.1111/cas.14149. Epub 2019 Sep 17.

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