Rimer B K, Schildkraut J M, Lerman C, Lin T H, Audrain J
Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, North Carolina 27705, USA.
Cancer. 1996 Jun 1;77(11):2348-55. doi: 10.1002/(SICI)1097-0142(19960601)77:11<2348::AID-CNCR25>3.0.CO;2-W.
Little is known about what factors influence women to participate its trials designed for women at high risk for breast cancer. Yet the recruitment phase is of utmost importance in determining whether the trial can achieve its goals. The purpose of this study was to examine predictors of participation in a risk counseling trial for first-degree relatives of breast cancer patients.
Subjects were identified by their relatives who had received a diagnosis of breast cancer at one of six institutions. Letters of introduction were sent to potentially eligible, unaffected relatives. They were informed about the risk counseling study and given the opportunity to decline. Letters were sent to 1392 first-degree relatives; of these, 1149 women were contacted for an interview and 14% refused. Of the 987 respondents, 47% accepted and 53% declined to participate. Bivariate and multivariate statistics were used to examine predictors of participation.
In the total sample, there were five significant multivariable predictors of participation: level of education, recent clinical breast examination (CBE), objective and perceived breast cancer risk, and any current use of alcohol. Participation was moderated by time since the relative's diagnosis. There was a statistically significant relationship to education such that women with a higher level of education were significantly more likely to participate if they were approached within 2 months of their relative's diagnosis of breast cancer.
Like many other kinds of trials, participants in this risk counseling trial were significantly more likely to have more than a high school education and more likely to be nonsmokers than the nonparticipants. They also were significantly more likely to drink alcohol (dichotomous measure), have had a recent CBE, and have higher subjective and objective breast cancer risks. Different types of recruitment strategies may be needed depending on the characteristics of the people being recruited and the timing of the invitation.
对于哪些因素会影响女性参与针对乳腺癌高危女性设计的试验，我们知之甚少。然而，招募阶段对于确定试验能否实现其目标至关重要。本研究的目的是探讨乳腺癌患者一级亲属参与风险咨询试验的预测因素。
通过在六个机构之一被诊断患有乳腺癌的亲属来确定研究对象。向可能符合条件的未受影响的亲属发送介绍信。告知他们有关风险咨询研究的情况，并给予他们拒绝的机会。共向1392名一级亲属发送了信件；其中，1149名女性被联系进行访谈，14%拒绝。在987名受访者中，47%接受并53%拒绝参与。采用双变量和多变量统计方法来检验参与的预测因素。
在总样本中，有五个参与的显著多变量预测因素：教育水平、近期临床乳腺检查（CBE）、客观和感知到的乳腺癌风险以及当前是否饮酒。自亲属诊断以来的时间对参与有调节作用。教育水平与参与之间存在统计学上的显著关系，即如果在亲属被诊断患有乳腺癌后的2个月内与教育水平较高的女性接触，她们参与的可能性显著更高。
与许多其他类型的试验一样，参与这项风险咨询试验的参与者比未参与者更有可能拥有高中以上学历且更有可能不吸烟。他们也更有可能饮酒（二分法测量）、近期接受过CBE检查，并且具有更高的主观和客观乳腺癌风险。根据被招募人群的特征和邀请时间，可能需要不同类型的招募策略。
