The perception of cancer risk in patients with prevalent Barrett's esophagus enrolled in an endoscopic surveillance program.
The perception of cancer risk in patients with prevalent Barrett's esophagus enrolled in an endoscopic surveillance program.
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参加内窥镜监测计划的巴雷特食管流行患者对癌症风险的看法。
DOI：
10.1016/j.gastro.2005.05.055
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Provenzale,Dawn
中科院分区：
文献类型：
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作者：
Shaheen,NicholasJ;Green,Bryan;Medapalli,RajK;Mitchell,KateL;Wei,JeffreyT;Schmitz,SarahM;West,LindsayM;Brown,Alphonso;Noble,Marc;Sultan,Shahnaz;Provenzale,Dawn
背景与目标巴雷特食管 (BE) 患者每年患食管腺癌的风险约为 0.5%。患者可能很难理解这种风险。这项研究评估了 BE 患者对癌症的感知风险，并将他们的风险估计与他们的医疗保健使用行为相关联。方法我们对在 2 个地点参与内窥镜监测计划的 BE 患者进行了调查：一所大学教学医院和一家退伍军人管理局医院。调查问卷还了解了他们的人口统计数据以及他们的健康信息来源。评估了医疗保健行为，包括医生就诊和内窥镜监测行为。患者被分类为风险高估者或非高估者。对高估者的特征以及医疗保健使用模式进行了评估。结果 118 名患者符合进入标准，其中 92 名 (78%) 完成了所有调查问卷。 68% 的患者高估了 1 年患癌症的风险，平均估计 1 年患癌症的风险为 13.6%。 38% 的患者也高估了终生风险。高估风险的患者更有可能是退伍军人管理局医疗中心的患者，有更多的症状反流，并且更有可能使用互联网获取医疗保健信息。高估者和非估计者之间的医生就诊次数没有显着差异（每年 1.2 次 vs 1.0，P = .20），内窥镜检查使用也没有显着差异（每 5 年 5.7 次内窥镜检查 vs 5.0，P = .42）。 结论 参加内窥镜监测计划的大多数患有普遍 BE 的患者高估了他们患食管腺癌的机会。有必要努力改善此类 BE 患者的教育。
Background&AimsPatients with Barrett’s esophagus (BE) have a risk of esophageal adenocarcinoma of approximately 0.5% per year. Patients may have difficulty understanding this risk. This study assessed the perceived risk of cancer in patients with BE, and correlated their risk estimates with their health care use behaviors.MethodsWe performed a survey of patients with BE participating in an endoscopic surveillance program at 2 sites: a university teaching hospital and a Veterans’ Administration hospital. A questionnaire also elicited their demographics as well as their sources of health information. Health care behaviors, including physician visits and endoscopic surveillance behaviors, were assessed. Patients were classified as either overestimators or nonoverestimators of risk. Characteristics of overestimators, as well as health care use patterns, were assessed.ResultsOne hundred eighteen patients met entry criteria, and 92 (78%) completed all the questionnaires. Sixty-eight percent of patients overestimated their 1-year risk of cancer, with a mean estimated 1-year cancer risk being 13.6%. The lifetime risk also was overestimated by 38% of patients. Patients who overestimated risk were more likely to be Veterans’ Administration medical center patients, have more symptomatic reflux, and were more likely to use the Internet to get health care information. There was no significant difference in physician visits between overestimators and nonestimators (1.2 visits per year vs 1.0, P = .20), nor in endoscopy use (5.7 endoscopies per 5-year period vs 5.0, P = .42).ConclusionsThe majority of patients with prevalent BE participating in an endoscopic surveillance program overestimated their chances of developing adenocarcinoma of the esophagus. Efforts to improve education of such patients with BE are warranted.