中低收入国家的癌症遗传服务：横断面调查评估对种系遗传检测的接受意愿和支付意愿。
Cancer Genetic Services in a Low- to Middle-Income Country: Cross-Sectional Survey Assessing Willingness to Undergo and Pay for Germline Genetic Testing.
机构信息
Department of Nursing, College of Medicine, University of Ibadan, Nigeria.
School of Occupational Health Nursing, University College Hospital, Ibadan, Nigeria.
出版信息
JCO Glob Oncol. 2023 Feb;9:e2100140. doi: 10.1200/GO.21.00140.
PURPOSE
Cancer genetic testing (CGT), a pathway to personalized medicine, is also being embraced in Nigeria. However, little is known about the influence of demographics and perceptions on individuals' willingness to access and pay for CGT. This study assessed patients' willingness to undergo CGT in southwest Nigeria as a catalyst for sustainable Cancer Risk Management Program.
METHODS
This was a cross-sectional study using semistructured questionnaire to interview 362 patients with cancer and 10 referred first-degree relatives between July 2018 and February 2020. Participants from three Nigerian teaching hospitals-University College Hospital, Ibadan, Lagos State University Teaching Hospital, Lagos, and Lagos University Teaching Hospital, Lagos, received genetic counseling and had subsequent CGT. Primary outcomes were willingness to undergo CGT in determining cancer risk and the willingness to pay for it. Ethical approval was from appropriate ethics committees of participating hospitals. Data were analyzed with SPSS version 22. Univariate comparison of categorical variables was performed by χ test, multivariate analysis by logistic regression.
RESULTS
The participants from University College Hospital (56.2%), Lagos State University Teaching Hospital (26.3%), and Lagos University Teaching Hospital (17.5%) were mostly female (98.4%). Mean age was 48.8 years ± 11.79. Three hundred twenty-two (86.6%) patients and first-degree relatives were willing to take the test, of whom 231 (71.1%) were willing to pay for it. more than half (53.6%) of the participants were willing to pay between N10,000 and N30,000, which is less than $100 US dollars. Sociodemographic variables and willingness to test showed no association ( > .05). Education and ethnicity were found to be associated with their willingness to pay for CGT ( ≤ .05).
CONCLUSION
Learning clinically relevant details toward cancer prevention informs health-related decisions in patients and relatives, a motivator for willingness to pay for genetic testing in low- and middle-income countries. Increased awareness may influence outcomes of cancer risk management.
目的
癌症基因检测（CGT）是个性化医疗的一种途径，也正在尼日利亚得到应用。然而，人们对人口统计学因素和认知对个人接受和支付 CGT 的意愿的影响知之甚少。本研究评估了西南尼日利亚患者接受 CGT 的意愿，作为可持续癌症风险管理计划的催化剂。
方法
这是一项横断面研究，使用半结构式问卷对 2018 年 7 月至 2020 年 2 月期间在三家尼日利亚教学医院（伊巴丹大学教学医院、拉各斯州立大学教学医院和拉各斯大学教学医院）的 362 名癌症患者和 10 名一级亲属进行了访谈。接受遗传咨询并随后进行 CGT 的参与者。主要结果是在确定癌症风险方面接受 CGT 的意愿以及为此付费的意愿。参与医院的适当伦理委员会批准了伦理审查。使用 SPSS 版本 22 进行数据分析。使用 χ 检验进行分类变量的单变量比较，使用逻辑回归进行多变量分析。
结果
来自大学教学医院（56.2%）、拉各斯州立大学教学医院（26.3%）和拉各斯大学教学医院（17.5%）的参与者主要是女性（98.4%）。平均年龄为 48.8 岁±11.79 岁。322 名（86.6%）患者和一级亲属愿意接受测试，其中 231 名（71.1%）愿意为此付费。超过一半（53.6%）的参与者愿意支付 N10,000 到 N30,000，不到 100 美元。社会人口统计学变量和测试意愿之间没有关联（>.05）。研究发现，教育和族裔与他们支付 CGT 的意愿有关（≤.05）。
结论
了解与癌症预防相关的临床细节会影响患者和亲属的健康相关决策，这是中低收入国家愿意支付基因检测费用的一个推动因素。提高认识可能会影响癌症风险管理的结果。
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