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癌症幸存者对遗传性癌症基因检测的认知与应用:一项2021年横断面的健康信息全国趋势调查(HINTS)-监测、流行病学和最终结果(SEER)研究

Awareness and utilization of genetic testing for hereditary cancers in cancer survivors: a cross-sectional 2021 HINTS-SEER study.

作者信息

Ramalingam Kirithiga, Li Stephen, McKinley Meg, Vanderpool Robin C, Nash Sarah H, Shariff-Marco Salma, Scheffler Aaron, Van Blarigan Erin L, DeRouen Mindy C

机构信息

Department of Surgery, University of California San Francisco, San Francisco, CA, USA.

Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.

出版信息

J Cancer Surviv. 2025 May 22. doi: 10.1007/s11764-025-01823-3.

Abstract

PURPOSE

We aimed to identify factors associated with genetic testing awareness and use among a large sample of US cancer survivors participating in NCI's Health Information National Trends Survey of cancer survivors identified through the Surveillance, Epidemiology, and End Results program, a unique pilot study expanding the number of cancer survivors typically captured by HINTS.

METHODS

We analyzed 2021 HINTS-SEER data to determine sociodemographic factors associated with awareness and utilization of germline genetic testing using survey-weight-adjusted multivariable logistic regression.

RESULTS

Of 1232 survivors (any site), the majority had breast (23%) or prostate (23%) cancer. Among the overall study population, 77% were aware of and 24% utilized genetic testing. Females and those with a college education, income over $100,000, or family history of cancer had greater odds of awareness compared to males, those with less than college education, income under $20,000, or no family history, respectively. Among prostate cancer survivors, those ≥ 65 years in age had lower odds of awareness. Females and the privately insured had greater odds of utilization compared to males and publicly insured, respectively. Those ≥ 65 years or retired had lower odds of utilization compared to < 65 years and being employed, respectively.

CONCLUSION

We identified sociodemographic factors associated with awareness and utilization of germline genetic testing among cancer survivors. Findings warrant further investigation to understand mechanisms underlying disparities in awareness and use of genetic testing.

IMPLICATIONS FOR CANCER SURVIVORS

This study highlights cancer survivor populations that may require additional support around awareness of and use of germline genetic testing.

摘要

目的

我们旨在确定参与美国国立癌症研究所(NCI)健康信息国家趋势调查(通过监测、流行病学和最终结果计划确定的癌症幸存者)的大量美国癌症幸存者中,与基因检测意识和使用相关的因素,这是一项独特的试点研究,扩大了通常由健康信息国家趋势调查(HINTS)涵盖的癌症幸存者数量。

方法

我们分析了2021年HINTS-SEER数据,使用调查权重调整后的多变量逻辑回归来确定与种系基因检测意识和利用相关的社会人口学因素。

结果

在1232名幸存者(任何部位)中,大多数患有乳腺癌(23%)或前列腺癌(23%)。在整个研究人群中,77%的人知晓基因检测,24%的人使用过基因检测。与男性、大学教育程度以下、收入低于2万美元或无家族病史的人相比,女性以及受过大学教育、收入超过10万美元或有癌症家族史的人知晓基因检测的几率更高。在前列腺癌幸存者中,年龄≥65岁的人知晓基因检测的几率较低。与男性和公共保险者相比,女性和私人保险者使用基因检测的几率分别更高。与年龄<65岁且在职的人相比,年龄≥65岁或已退休的人使用基因检测的几率分别较低。

结论

我们确定了癌症幸存者中与种系基因检测意识和使用相关的社会人口学因素。研究结果值得进一步调查,以了解基因检测意识和使用差异背后的机制。

对癌症幸存者的启示

本研究强调了可能需要在种系基因检测意识和使用方面获得额外支持的癌症幸存者群体。

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