Physicians' and women's views on hormone therapy and breast cancer risk after the WHI: a qualitative study.
Physicians' and women's views on hormone therapy and breast cancer risk after the WHI: a qualitative study.
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WHI 后医生和女性对激素治疗和乳腺癌风险的看法：一项定性研究。
DOI：
10.1080/03630240903158446
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发表时间：
2009
期刊：
影响因子：
1.6
通讯作者：
Newton,KatherineM
中科院分区：
文献类型：
--
作者：
Nekhlyudov,Larissa;Bush,Terry;Bonomi,AmyE;Ludman,EvetteJ;Newton,KatherineM
背景：自妇女健康倡议的研究结果发布以来，绝经期激素治疗（HT）的使用显著下降，但医生和妇女对乳腺癌的担忧在多大程度上促成了这一变化尚不清楚。我们的研究探讨了医生和女性对激素治疗和乳腺癌风险的看法。方法：我们对华盛顿州和马萨诸塞州两个大型综合医疗保健系统的22名初级保健医生和45名女性患者进行了定性深入访谈。结果：对乳腺癌风险的担忧在医生和妇女开始和继续激素治疗的决策过程中被权衡。对女性来说，控制更年期症状很重要，可能比她们对乳腺癌潜在风险的担忧更重要。尽管担心它与乳腺癌风险增加的关系，医生们愿意考虑激素治疗来控制妇女的更年期症状，但对缺乏可用的非激素治疗替代方案感到沮丧。大多数医生和一些妇女都知道“妇女健康倡议”，其研究结果似乎影响了她们对激素治疗和乳腺癌风险的看法，尽管这两组人对研究结果和影响仍有疑问。结论：我们的定性研究表明，在妇女健康倡议之后，对乳腺癌风险的担忧权衡了医生和妇女开始和继续激素治疗的决定，但更年期症状通常指导使用。
Background: The use of menopausal hormone therapy (HT) has significantly declined since the release of the Women's Health Initiative findings, but to what extent physicians' and women's concerns about breast cancer contributed to this change is unknown. Our study explored physicians' and women's beliefs about hormone therapy and breast cancer risk.Methods: We conducted qualitative in-depth interviews with 22 primary care physicians and 45 female patients at two large integrated health care delivery systems in Washington State and Massachusetts.Results: Concerns about breast cancer risk weighed into the decision-making process for physicians and women in initiating and continuing hormone therapy. For women, control of menopausal symptoms was important and possibly outweighed their concerns about the potential risks of breast cancer. Though concerned about its association with increasing breast cancer risk, physicians were willing to consider hormone therapy to manage women's menopausal symptoms but were frustrated about the lack of available non-hormone therapy alternatives. Most physicians and some women were aware of the Women's Health Initiative, and its findings appeared to influence their beliefs about hormone therapy and breast cancer risk, though doubts remained among both groups about the study findings and implications.Conclusions: Our qualitative study suggests that after the Women's Health Initiative, concerns about breast cancer risk weighed into decisions to initiate and continue hormone therapy for both physicians and women, but menopausal symptoms often directed use.