Hopwood P
CRC Psychological Medicine Group, Christie Hospital NHS Trust, Withington, Manchester, UK.
Patient Educ Couns. 1997 Sep-Oct;32(1-2):19-31. doi: 10.1016/s0738-3991(97)00060-8.
There has been a rapid expansion of genetics research in the field of cancer since cancer predisposing genes are now known to cause a proportion of common cancers as well as rarer cancer syndromes. As a result, the psychosocial impact of being at high risk of cancer has become a focus of evaluation, and studies are being reported which set out to evaluate both the uptake and psychological outcome of genetic counselling, testing and surveillance. Available data concerning psychological aspects are reviewed, including for example, possible implications of genetic testing, attitudes and uptake of breast screening and accuracy of women's risk estimates. Work is in progress to assess the more controversial areas of prophylactic mastectomy, and chemoprevention. Other research examines the longer term impact of belonging to a Cancer Family, and of interventions offered to high risk families. This is crucial since the uptake of counselling and testing is likely to be much greater in cancer prone families than those with other genetic disorders, yet detection and prevention strategies are still unevaluated for important genetically determined cancers such as breast cancer.
自从已知癌症易感基因会导致一定比例的常见癌症以及较为罕见的癌症综合征以来，癌症领域的遗传学研究迅速发展。因此，癌症高风险所带来的心理社会影响已成为评估的焦点，并且有研究报告开始评估遗传咨询、检测及监测的接受情况和心理结果。本文回顾了有关心理方面的现有数据，例如基因检测的可能影响、乳腺筛查的态度和接受情况以及女性风险评估的准确性。目前正在开展工作，以评估预防性乳房切除术和化学预防等更具争议性的领域。其他研究则考察了属于癌症家族的长期影响以及为高风险家族提供的干预措施。这至关重要，因为与其他遗传疾病患者相比，癌症易感家族接受咨询和检测的可能性要大得多，但对于乳腺癌等重要的遗传决定癌症，其检测和预防策略仍未得到评估。
