Macdonald K G, Doan B, Kelner M, Taylor K M
Department of Administrative Studies and Nursing, York University, Ont.
CMAJ. 1996 Feb 15;154(4):457-64.
Testing for susceptibility to heritable breast, ovarian and colon cancer has unique psychosocial costs. Negative test results may not be sufficient to relieve anxiety, and positive results can cause sufficient distress to compromise patient compliance with surveillance and risk reduction measures. More needs to be learned about how sociocultural factors affect the understanding of risk, how decisions to undergo testing are made and how information about increased risk affects family dynamics. As the demand for testing and counselling grows, health care providers will be faced with new challenges and dilemmas. A better understanding of genetics by the public is needed to mitigate deterministic attitudes that can lead to the neglect of health promotion. Also of concern are the socioeconomic implications of being identified as having a high risk for heritable cancer and the dangers inherent in using genetics to explain sociological phenomena. Health care providers must take the lead in ensuring that developments in genetics are used to the benefit of all.
检测遗传性乳腺癌、卵巢癌和结肠癌的易感性会带来独特的心理社会成本。阴性检测结果可能不足以缓解焦虑，而阳性结果可能会造成足够的困扰，从而影响患者对监测和风险降低措施的依从性。关于社会文化因素如何影响对风险的理解、如何做出进行检测的决定以及风险增加的信息如何影响家庭动态，还有更多需要了解的地方。随着检测和咨询需求的增长，医疗保健提供者将面临新的挑战和困境。需要公众对遗传学有更好的理解，以减轻可能导致忽视健康促进的决定论态度。同样令人担忧的是，被认定为遗传性癌症高风险人群的社会经济影响，以及用遗传学解释社会学现象所固有的危险。医疗保健提供者必须带头确保遗传学的发展造福所有人。
