Dibble Kate E, Donorfio Laura K M, Britner Preston A, Bellizzi Keith M
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd U-1058, Storrs, CT 06269, USA.
Gynecol Oncol Rep. 2022 May 2;41:100989. doi: 10.1016/j.gore.2022.100989. eCollection 2022 Jun.
It is estimated that 12.5% of women will be diagnosed with breast cancer and 1.10% with ovarian cancer during their lifetime. Although less common, women with these mutations have a 11-72% increased risk of breast/ovarian cancers and are hereditary. Genetic testing/counseling presents the opportunity to identify carriers of genetic mutations before a cancer diagnosis.
Thirty-four -positive women (with and without histories of breast/ovarian cancers) were recruited through online national support groups to gain a better understanding of their genetic testing/counseling perceptions and experiences. After confirming eligibility, they were invited to participate in either a telephone or webcam interview. Interview transcripts were analyzed using qualitative thematic text analysis and descriptive coding techniques.
Six major themes emerged, capturing the perceptions and experiences of genetic testing/counseling for these women: 1) Emotional Reactions to Results and Genetic Counseling, 2) Future Recommendations, 3) Family Solidarity and Support, 4) Experiences with the Healthcare System, 5) Preventive Concerns and Decisions, and 6) Sources Affecting Perceived Risk. Two subthemes also emerged within the first theme, which are termed "Pre-vivor," and "Testing Intuition."
Participants indicated that genetic testing/counseling improvements would be helpful for women in this population surrounding quality care, including sensitivity training for healthcare professionals involved in testing/counseling, additional educational resources, and increased emotional and financial support. Although these recommendations may be beneficial, more widespread research with greater generalizability to disparate groups may be necessary prior to implementation.
据估计,12.5%的女性在其一生中会被诊断出患有乳腺癌,1.10%的女性会被诊断出患有卵巢癌。虽然这些突变不太常见,但携带这些突变的女性患乳腺癌/卵巢癌的风险会增加11%-72%,且具有遗传性。基因检测/咨询为在癌症诊断前识别基因突变携带者提供了机会。
通过在线全国性支持小组招募了34名检测呈阳性的女性(有或没有乳腺癌/卵巢癌病史),以更好地了解她们对基因检测/咨询的看法和经历。确认符合条件后,邀请她们参加电话或网络摄像头访谈。使用定性主题文本分析和描述性编码技术对访谈记录进行分析。
出现了六个主要主题,反映了这些女性对基因检测/咨询的看法和经历:1)对检测结果和基因咨询的情绪反应,2)未来建议,3)家庭团结与支持,4)与医疗保健系统的经历,5)预防方面的担忧和决策,6)影响感知风险的因素。在第一个主题中还出现了两个子主题,分别称为“预生存者”和“检测直觉”。
参与者表示,基因检测/咨询的改进将有助于该人群中的女性获得高质量护理,包括对参与检测/咨询的医疗保健专业人员进行敏感性培训、提供更多教育资源以及增加情感和经济支持。尽管这些建议可能有益,但在实施之前可能需要进行更广泛的研究,以使其对不同群体具有更大的普遍性。