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家庭激励能否提高男性对家族性突变级联筛查的接受度?

Can Family Motivation Enhance Men's Uptake of Cascade Screening for Familial Mutations?

作者信息

Ongaro Giulia, Petrocchi Serena, Calvello Mariarosaria, Bonanni Bernardo, Feroce Irene, Pravettoni Gabriella

机构信息

Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (IEO), IRCCS, Milan, Italy.

Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center (MSK), New York, NY, USA.

出版信息

Am J Mens Health. 2025 Jul-Aug;19(4):15579883251343962. doi: 10.1177/15579883251343962. Epub 2025 Aug 7.

DOI:10.1177/15579883251343962
PMID:40772289
Abstract

Pathogenic variants in the and genes increase the relative and absolute risks of developing breast, ovarian, prostate, and pancreatic cancer. Clinical guidelines recommend cascade screening (CS) to enhance the identification of at-risk relatives. Despite the benefits of CS in facilitating access to appropriate cancer screening and risk-reduction strategies, CS uptake remains relatively low, particularly among at-risk men. Men's decisions regarding CS appear to be driven more by familial rather than individual disease risk, framing the decision as a family duty. Little is known about the motivational factors that could encourage men's participation in CS. This randomized controlled trial aimed to evaluate the effectiveness of two first-person, gain-framed messages in promoting CS intention among at-risk men: one featuring a self-referred narrative (SM) and the other a family-referred narrative (FM). A total of 110 male first-degree relatives of female carriers were randomized into two groups. -tests revealed no significant difference between groups in perceived message quality. Additionally, after controlling for age, the type of message received did not significantly influence participants' levels of intention to undergo CS. These findings highlight the need for further exploration of the complex motivational factors influencing at-risk men's adherence to CS. Future research should consider alternative health communication strategies tailored to different motivational drivers.

摘要

BRCA1和BRCA2基因的致病性变异会增加患乳腺癌、卵巢癌、前列腺癌和胰腺癌的相对风险和绝对风险。临床指南推荐进行级联筛查(CS),以加强对高危亲属的识别。尽管CS在促进获得适当的癌症筛查和风险降低策略方面有诸多益处,但CS的接受率仍然相对较低,尤其是在高危男性中。男性对于CS的决策似乎更多地受家族因素而非个人疾病风险驱动,将该决策视为一项家庭责任。对于可能鼓励男性参与CS的动机因素知之甚少。这项随机对照试验旨在评估两条第一人称、获益框架信息在促进高危男性CS意愿方面的有效性:一条以自我推荐的叙述为特色(SM),另一条以家庭推荐的叙述为特色(FM)。总共110名女性BRCA1/2携带者的男性一级亲属被随机分为两组。t检验显示两组在感知信息质量方面没有显著差异。此外,在控制年龄后,所接收信息的类型并未显著影响参与者接受CS的意愿水平。这些发现凸显了进一步探索影响高危男性坚持CS的复杂动机因素的必要性。未来的研究应考虑针对不同动机驱动因素量身定制的替代健康传播策略。

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本文引用的文献

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Assessing the acceptability and appropriateness of a psychoeducational graphic novel about inherited cancer risk designed for men.评估一本为男性设计的关于遗传性癌症风险的心理教育漫画小说的可接受性和适宜性。
J Genet Couns. 2025 Apr;34(2):e1954. doi: 10.1002/jgc4.1954. Epub 2024 Aug 7.
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Hereditary Cancer Syndromes: A Comprehensive Review with a Visual Tool.遗传性癌症综合征:全面综述及可视化工具
Genes (Basel). 2023 Apr 30;14(5):1025. doi: 10.3390/genes14051025.
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Psychological Determinants of Men's Adherence to Cascade Screening for .
心理因素对男性参与级联筛查的影响。
Curr Oncol. 2022 Apr 2;29(4):2490-2503. doi: 10.3390/curroncol29040203.
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A randomized controlled trial comparing self-referred message to family-referred message promoting men's adherence to evidence-based guidelines on BRCA1/2 germline genetic testing: A registered study protocol.一项比较自我推荐信息与家庭推荐信息促进男性遵循 BRCA1/2 种系基因突变检测循证指南的依从性的随机对照试验:一项注册研究方案。
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Improving our model of cascade testing for hereditary cancer risk by leveraging patient peer support: a concept report.通过利用患者同伴支持来改进我们的遗传性癌症风险级联检测模型:概念报告。
Hered Cancer Clin Pract. 2021 Sep 26;19(1):40. doi: 10.1186/s13053-021-00198-7.
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Effects of Message Framing on Cancer Prevention and Detection Behaviors, Intentions, and Attitudes: Systematic Review and Meta-analysis.信息框架对癌症预防和检测行为、意图和态度的影响:系统评价和荟萃分析。
J Med Internet Res. 2021 Sep 16;23(9):e27634. doi: 10.2196/27634.
7
Engaging Men With BRCA-Related Cancer Risks: Practical Advice for BRCA Risk Management From Male Stakeholders.参与具有 BRCA 相关癌症风险的男性:来自男性利益相关者的 BRCA 风险管理实用建议。
Am J Mens Health. 2020 May-Jun;14(3):1557988320924932. doi: 10.1177/1557988320924932.
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Low rates of cascade genetic testing among families with hereditary gynecologic cancer: An opportunity to improve cancer prevention.遗传性妇科癌症家族中级联遗传检测率低:改善癌症预防的机会。
Gynecol Oncol. 2020 Jan;156(1):140-146. doi: 10.1016/j.ygyno.2019.11.005. Epub 2019 Nov 25.
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Persuasive messages can be more effective when repeated: A comparative survey assessing a message to seek help for depression among Japanese adults.当信息被重复时,其说服力可能会更强:一项比较性调查评估了一项针对日本成年人寻求抑郁帮助的信息。
Patient Educ Couns. 2020 Apr;103(4):811-818. doi: 10.1016/j.pec.2019.11.008. Epub 2019 Nov 13.
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"How do we rally around the one who was positive?" Familial uncertainty management in the context of men managing BRCA-related cancer risks.我们如何团结那个阳性患者?男性管理 BRCA 相关癌症风险背景下的家庭不确定性管理。
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