Ye Xin, Xu Ting, Cao Jun, Li Gang, Zhuang Ming, Hu Guangfu, Chen Hongliang, Wang Min, Wang Jie
Department of Breast Surgery, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
PLoS One. 2025 May 8;20(5):e0322526. doi: 10.1371/journal.pone.0322526. eCollection 2025.
Genetic testing is widely recommended in the diagnosis and management of breast cancer. This study aimed to investigate the knowledge, attitude, and practice (KAP) toward genetic testing in Chinese patients with breast cancer. This multicenter cross-sectional study enrolled breast cancer patients in seven public hospitals in Shanghai, China, between November 2022 and January 2023. A self-administered web-based questionnaire was used to collect the participants' demographic information and their KAP regarding genetic testing. A total of 592 valid questionnaires were collected in this study; 145 (24.49%) patients underwent genetic testing, and 20.61% of the patients never learned about genetic testing. The knowledge, attitude, and practice scores were 4.59 ± 4.49 (22.95%, possible range: 0-20), 16.72 ± 2.92 (83.60%, possible range: 0-20), and 23.67 ± 5.18 (73.97%, possible range: 0-32), respectively. Multivariable logistic regression showed that knowledge (OR = 1.21, 95%CI: 1.51-1.28, P < 0.001), attitude (OR = 1.10, 95%CI: 1.01-1.19, P = 0.027), Jiangsu Province (OR = 0.40, 95%CI: 0.19-0.84, P = 0.016), monthly income of 5000-10,000 CNY (OR = 0.46, 95%CI: 0.25-0.86, P = 0.015), disease duration of 5-10 years (OR = 0.50, 95%CI: 0.27-0.94, P = 0.030) and disease duration of ≥ 10 years (OR = 0.26, 95%CI: 0.11-0.60, P = 0.002), triple-negative subtype (OR = 3.45, 95%CI: 1.51-7.85, P = 0.003) were independently associated with patients' behavior of undergoing genetic testing. The structural equation modeling showed that knowledge directly positively influenced attitude (β = 0.343, P < 0.001), while attitude directly positively influenced practice (β = 0.942, P < 0.001). Chinese patients with breast cancer demonstrated poor knowledge, positive attitude, and suboptimal practice toward genetic testing. More education and counseling on genetic testing for patients are necessary.
基因检测在乳腺癌的诊断和治疗中被广泛推荐。本研究旨在调查中国乳腺癌患者对基因检测的知识、态度和行为(KAP)。这项多中心横断面研究于2022年11月至2023年1月期间在中国上海的七家公立医院招募乳腺癌患者。使用基于网络的自填式问卷收集参与者的人口统计学信息及其关于基因检测的KAP。本研究共收集到592份有效问卷;145名(24.49%)患者接受了基因检测,20.61%的患者从未了解过基因检测。知识、态度和行为得分分别为4.59±4.49(22.95%,可能范围:0 - 20)、16.72±2.92(83.60%,可能范围:0 - 20)和23.67±5.18(73.97%,可能范围:0 - 32)。多变量逻辑回归显示,知识(OR = 1.21,95%CI:1.51 - 1.28,P < 0.001)、态度(OR = 1.10,95%CI:1.01 - 1.19,P = 0.027)、江苏省(OR = 0.40,95%CI:0.19 - 0.84,P = 0.016)、月收入5000 - 10000元人民币(OR = 0.46,95%CI:0.25 - 0.86,P = 0.015)、病程5 - 10年(OR = 0.50,95%CI:0.27 - 0.94,P = 0.030)和病程≥10年(OR = 0.26,95%CI:0.11 - 0.60,P = 0.002)、三阴性亚型(OR = 3.45,95%CI:1.51 - 7.85,P = 0.003)与患者接受基因检测的行为独立相关。结构方程模型显示,知识直接正向影响态度(β = 0.343,P < 0.001),而态度直接正向影响行为(β = 0.942,P < 0.001)。中国乳腺癌患者对基因检测的知识掌握不足、态度积极但行为欠佳。有必要为患者提供更多关于基因检测的教育和咨询。