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初级保健提供者对多癌种早期检测面板的看法。

Perspectives of primary care providers regarding multicancer early detection panels.

机构信息

Department of Hematology/Oncology, University of Colorado Anschutz School of Medicine, Aurora, CO, United States.

Department of Family Medicine, Mayo Clinic, Jacksonville, FL, United States.

出版信息

Einstein (Sao Paulo). 2024 Aug 23;22:eAO0771. doi: 10.31744/einstein_journal/2024AO0771. eCollection 2024.

Abstract

OBJECTIVE

Multicancer early detection panels have recently become available to patients with healthcare provider prescriptions and available funds. These tests utilize circulating tumor DNA (ctDNA) to screen more than 50 cancers using a single blood sample. However, perspectives and data on how the deployment of these tests may impact the practices of primary care providers in terms of implementation, interpretation, documentation, and costs are limited. This study aimed to assess the perspectives of primary care providers regarding the integration of multicancer early detection panels into clinical practice.

METHODS

We used a survey to assess the opinions and perspectives of primary care providers, including physicians, nurse practitioners, and physician assistants, across a multistate, tertiary healthcare system. We used a single form consisting of novel questions on familiarity with multi-cancer early detection panels, cost, healthcare equity, documentation, medicolegal, and other concerns. The subgroup analysis was consistent with stratification based on familiarity with ctDNA-based tests and their roles in clinical practice.

RESULTS

Most respondents were unfamiliar with multicancer early detection panels and had not used ctDNA-based tests. Most primary care providers suggested that they would reorder multicancer early detection panel testing at 1- to 5-year intervals and prefer subspecialists for both ordering multicancer early detection panels as well as interpreting their results. Relative concerns differed between physicians and nonphysicians.

CONCLUSION

The integration of multicancer early detection panels into primary care practice requires careful planning and consideration for the management of increased clinical load, interpretation of results, and cost management.

摘要

目的

多癌种早期检测面板最近已提供给有医疗保健提供者处方和可用资金的患者。这些测试利用循环肿瘤 DNA(ctDNA),通过单次血液样本筛查 50 多种癌症。然而,关于这些测试的部署如何可能在实施、解释、记录和成本方面影响初级保健提供者的实践,人们的看法和数据有限。本研究旨在评估初级保健提供者对将多癌种早期检测面板纳入临床实践的看法。

方法

我们使用问卷调查评估了来自多州三级医疗保健系统的初级保健提供者(包括医生、护士从业者和医师助理)的意见和看法。我们使用了一种单一的表格,其中包含有关多癌种早期检测面板的熟悉程度、成本、医疗保健公平性、记录、医疗法律和其他问题的新问题。亚组分析与基于 ctDNA 测试的熟悉程度及其在临床实践中的作用的分层一致。

结果

大多数受访者不熟悉多癌种早期检测面板,也没有使用过基于 ctDNA 的测试。大多数初级保健提供者建议他们将多癌种早期检测面板的检测间隔设置为 1 至 5 年,并希望由专科医生来同时开单和解读多癌种早期检测面板的结果。医生和非医生之间的相对关注点不同。

结论

将多癌种早期检测面板纳入初级保健实践需要仔细规划和考虑增加的临床负担管理、结果解释和成本管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b211/11323832/660f96a62a40/2317-6385-eins-22-eAO0771-gf01.jpg

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