Preferences of women evaluating risks of tamoxifen (POWER) study of preferences for tamoxifen for breast cancer risk reduction
Preferences of women evaluating risks of tamoxifen (POWER) study of preferences for tamoxifen for breast cancer risk reduction
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DOI：
10.1002/cncr.20981
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发表时间：
2005-05-15
期刊：
影响因子：
6.2
通讯作者：
Henderson, S
中科院分区：
文献类型：
--
作者：
Melnikow, J;Paterniti, D;Henderson, S
背景本研究的目的是了解风险合格的妇女对使用他莫昔芬降低乳腺癌风险的态度和偏好。在一所大学的医疗中心和社区进行了一项横断面的，混合方法的访谈研究。参与者是估计5年乳腺癌风险>= 1.7%且既往无乳腺癌的女性。访谈以英语或西班牙语进行。访谈包括一个15分钟的标准化教育会议，讨论他莫昔芬的潜在益处和危害，然后是关于参与者服用他莫昔芬的倾向和对其决定重要的因素的封闭式和开放式问题。包括一份人口统计学问卷、一项关于他莫昔芬潜在益处和危害的知识测试以及一次访谈评估。255名妇女完成了访谈。他们估计的平均5年乳腺癌风险为2.8%;他们的平均自我感知5年风险为32.7%。教育干预后，45名妇女（17.6%）倾向于服用他莫昔芬。非常高风险的妇女（> 3.5%）并不比风险较低的妇女（1.7-3.5%）更倾向于服用它。在多变量分析中，较低的收入，对他莫昔芬有效性的信心，以及对骨折的担忧与倾向于服用他莫昔芬相关;对肺栓塞，性交困难，白内障和自我感知的乳腺癌风险低的担忧与服用他莫昔芬呈负相关。参与者对不良反应表示担忧。在接受了关于潜在益处和危害的教育后，不到20%的女性对他莫昔芬感兴趣，尽管自我认为乳腺癌风险很高。候选的化学预防剂必须具有很少的潜在副作用才能获得广泛接受。(c)2005年美国癌症协会。
BACKGROUND. The objective of this study was to understand the attitudes and preferences of risk-eligible women regarding use of tamoxifen for breast cancer risk reduction.METHODS. A cross-sectional, mixed-methods interview study was conducted at a university medical center and at community sites. Participants were women who had an estimated 5-year breast cancer risk >= 1.7% and no prior breast cancer. Interviews were conducted in English or Spanish. The interview included a 15-minute, standardized educational session on the potential benefits and harms of tamoxifen followed by close-ended and open-ended questions about participants' inclinations to take tamoxifen and factors important to their decision. A demographic questionnaire, a test on knowledge of potential benefits and harms of tamoxifen, and an interview evaluation were included.RESULTS. Two hundred fifty-five women completed interviews. Their estimated mean 5-year breast cancer risk was 2.8%; and their mean self-perceived 5-year risk was 32.7%. After the educational intervention, 45 women (17.6%) were inclined to take tamoxifen. Very high risk women (> 3.5%) were no more inclined to take it than women with lower risk (1.7-3.5%). In a multivariable analysis, lower income, confidence in the effectiveness of tamoxifen, and concern about fractures were associated with being inclined to take it; concern about pulmonary embolism, dyspareunia, cataracts, and low self-perceived breast cancer risk were associated negatively with taking tamoxifen. Participants expressed concerns about adverse effects.CONCLUSIONS. Less than 20% of women were interested in tamoxifen after education about potential benefits and harms, despite a very high self-perceived breast cancer risk. Candidate chemoprevention agents must have few potential adverse effects to achieve widespread acceptance. (c) 2005 American Cancer Society.