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传播风险与癌症预防概况——一项探索性研究,考察美国中西部非裔美国人和拉丁裔对癌症相关基因咨询与检测的认知。

Communicating risk and the landscape of cancer prevention - an exploratory study that examines perceptions of cancer-related genetic counseling and testing among African Americans and Latinos in the Midwest.

作者信息

Lumpkins Crystal Y, Nelson Rafaela, Twizele Zawadi, Ramírez Mariana, Kimminau Kim S, Philp Alisdair, Mustafa Reem A, Godwin Andrew K

机构信息

Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.

Pediatrics Department, University of Kansas Medical Center, Kansas City, KS, USA.

出版信息

J Community Genet. 2023 Apr;14(2):121-133. doi: 10.1007/s12687-022-00629-5. Epub 2023 Mar 17.

Abstract

African American (AA) and Latino populations are impacted disproportionately by cancer incidence and mortality compared to the general US population. Contributing to these rates are multiple inheritable cancers that impact both men and women. Some of these diseases may be detected through genetic counseling and germline DNA testing; however, AA and Latinos are unaware and have limited knowledge and thus significantly underutilize these services and technologies. Research to detect influencing factors to testing uptake has also been slow due to multiple factors. The research team followed a community-based participatory research (CBPR) approach and worked with a Community Advisory Board composed of cancer survivors and co-survivors to design the exploratory study. Six focus groups were held with a pilot sample of African Americans and Latinos who self-reported to be at-risk for cancer (N = 53). The study was held over a 2-month period where attitudes, perceptions, and beliefs about cancer risk and preference regarding cancer-related genetic counseling and testing risk communication were explored. Themes that emerged included (1) the lack of knowledge about cancer-related genetic counseling and testing; (2) cancer is feared often; (3) cancer-related genetic testing was perceived as something that could help but was also perceived as unnecessary testing that exposed individuals to medical harm; and (4) benefits to test were perceived as favorable for medical personnel but not for the patient. Implications of the study provide a unique lens to explore how lived experiences among AA and Latinos may inform strategic risk communication about cancer-related genetic counseling and testing and help advance cancer health equity. Participants viewed cancer genetic testing as important cancer risk prevention strategies. Identification of perceptions of cancer risk and cancer-related genetic counseling and testing in collaboration with members of the community is needed to bolster communication efforts among these populations.

摘要

与美国普通人群相比,非裔美国人和拉丁裔人群受癌症发病率和死亡率的影响尤为严重。多种遗传性癌症导致了这些比率,这些癌症对男性和女性都有影响。其中一些疾病可以通过遗传咨询和生殖系DNA检测来发现;然而,非裔美国人和拉丁裔对此并不了解,知识有限,因此这些服务和技术的利用率极低。由于多种因素,检测影响检测接受率的因素的研究也进展缓慢。研究团队采用了基于社区的参与性研究(CBPR)方法,并与一个由癌症幸存者和共同幸存者组成的社区咨询委员会合作设计了这项探索性研究。对6个焦点小组进行了研究,样本为自我报告有癌症风险的非裔美国人和拉丁裔(N = 53)。该研究持续了2个月,探讨了对癌症风险的态度、看法和信念,以及对癌症相关遗传咨询和检测风险沟通的偏好。出现的主题包括:(1)对癌症相关遗传咨询和检测缺乏了解;(2)经常害怕癌症;(3)癌症相关基因检测被认为有帮助,但也被视为不必要的检测,会使个体受到医疗伤害;(4)检测的好处被认为对医务人员有利,但对患者不利。该研究的意义为探索非裔美国人和拉丁裔的生活经历如何为癌症相关遗传咨询和检测的战略风险沟通提供信息,并有助于促进癌症健康公平提供了一个独特的视角。参与者将癌症基因检测视为重要的癌症风险预防策略。需要与社区成员合作,确定对癌症风险以及癌症相关遗传咨询和检测的看法,以加强这些人群之间的沟通努力。

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