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癌症种系易感性患者信息单页的共同设计:英国癌症遗传学组(UKCGG)、英国癌症研究中心(CRUK)资助的 CanGene-CanVar 项目和遗传护士顾问协会(AGNC)为临床实践提供的建议。

Co-design of patient information leaflets for germline predisposition to cancer: recommendations for clinical practice from the UK Cancer Genetics Group (UKCGG), Cancer Research UK (CRUK) funded CanGene-CanVar Programme and the Association of Genetic Nurse Counsellors (AGNC).

机构信息

Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK

Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK.

出版信息

J Med Genet. 2024 Jan 19;61(2):142-149. doi: 10.1136/jmg-2023-109440.

Abstract

BACKGROUND

Testing for germline pathogenic variants (GPVs) in cancer predisposition genes is increasingly offered as part of routine care for patients with cancer. This is often urgent in oncology clinics due to potential implications on treatment and surgical decisions. This also allows identification of family members who should be offered predictive genetic testing. In the UK, it is common practice for healthcare professionals to provide a patient information leaflet (PIL) at point of care for diagnostic genetic testing in patients with cancer, after results disclosure when a GPV is identified, and for predictive testing of at-risk relatives. Services usually create their own PIL, resulting in duplication of effort and wide variability regarding format, content, signposting and patient input in co-design and evaluation.

METHODS

Representatives from UK Cancer Genetics Group (UKCGG), Cancer Research UK (CRUK) funded CanGene-CanVar programme and Association of Genetic Nurse Counsellors (AGNC) held a 2-day meeting with the aim of making recommendations for clinical practice regarding co-design of PIL for germline cancer susceptibility genetic testing. Lynch syndrome and haematological malignancies were chosen as exemplar conditions.

RESULTS

Meeting participants included patient representatives including as co-chair, multidisciplinary clinicians and other experts from across the UK. High-level consensus for UK recommendations for clinical practice was reached on several aspects of PIL using digital polling, including that PIL should be offered, accessible, co-designed and evaluated with patients.

CONCLUSIONS

Recommendations from the meeting are likely to be applicable for PIL co-design for a wide range of germline genetic testing scenarios.

摘要

背景

对癌症易感性基因中的种系致病性变异(GPV)进行检测,作为癌症患者常规护理的一部分,越来越多地被采用。由于这可能对治疗和手术决策产生影响,因此在肿瘤学临床中通常较为紧迫。这也使得能够识别出应向其提供预测性基因检测的家庭成员。在英国,在癌症患者进行诊断性基因检测时,医护人员在提供检测结果后,通常会在就诊时为患者提供一份患者信息传单(PIL),如果发现 GPV,则为患者提供,并且为有风险的亲属提供预测性检测。服务机构通常会创建自己的 PIL,从而导致在格式、内容、引导以及患者共同设计和评估中的投入方面存在重复的工作和广泛的差异。

方法

英国癌症遗传学组(UKCGG)、英国癌症研究(CRUK)资助的 CanGene-CanVar 计划和遗传护士顾问协会(AGNC)的代表举行了为期两天的会议,目的是就种系癌症易感性遗传检测的 PIL 共同设计提出临床实践建议。选择林奇综合征和血液恶性肿瘤作为范例条件。

结果

会议参与者包括患者代表,包括联合主席、多学科临床医生和来自英国各地的其他专家。使用数字投票,与会者就 PIL 的几个方面达成了关于临床实践的高级别共识,包括应该提供 PIL,使其具有可及性,并与患者共同设计和评估。

结论

会议提出的建议可能适用于广泛的种系基因检测场景的 PIL 共同设计。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cc0/11881048/7267f325a5ba/jmg-61-2-g001.jpg

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