Children's Cancer and Environmental Exposures: Professional Attitudes and Practices.
Children's Cancer and Environmental Exposures: Professional Attitudes and Practices.
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DOI：
10.1097/mph.0000000000000416
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发表时间：
2015-10
期刊：
影响因子：
--
通讯作者：
Dahl GV
中科院分区：
文献类型：
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作者：
Zachek CM;Miller MD;Hsu C;Schiffman JD;Sallan S;Metayer C;Dahl GV
文本中提供了补充数字内容。世界范围内的流行病学研究提供了大量证据，证明环境暴露对儿童癌症的发展有贡献，但这一知识尚未纳入照顾患有这种疾病的儿童的临床医生的常规实践中。为了确定这种缺陷的基础，我们试图评估儿科血液学家和肿瘤学家的环境病史采集行为和对环境健康的看法。一项基于网络的调查于2012年6月至10月发送给来自20家美国机构的427名儿科肿瘤学家、研究员和执业护士，总体回复率为45%。调查答复表明，环境暴露是临床医生关注的问题。绝大多数的受访者（88%）报告收到的问题，从家庭之间的关系，某些环境暴露和癌症，他们经常treat. However，缺乏舒适与这些话题似乎限制了他们的讨论与家庭的作用，环境暴露在儿童癌症发病机制。虽然77%的受访者怀疑他们看到的一些病例有环境起源，但他们获取环境历史的方法差异很大。超过90%的受访者认为，更多地了解环境暴露与儿童癌症之间的关联将有助于解决患者的这些问题。虽然参与机构的规模和代表性有限，但本次调查的结果表明，需要增加对血液学/肿瘤学临床医生的培训，使其了解与癌症相关的环境健康暴露，并及时翻译临床医生阅读的生物医学期刊中的新兴研究结果。
Supplemental Digital Content is available in the text. Epidemiologic studies worldwide have provided substantial evidence of the contributions of environmental exposures to the development of childhood cancer, yet this knowledge has not been integrated into the routine practice of clinicians who care for children with this disease. To identify the basis of this deficit, we sought to assess the environmental history-taking behavior and perceptions of environmental health among pediatric hematologists and oncologists. A web-based survey was sent from June to October 2012 to 427 pediatric oncologists, fellows, and nurse practitioners from 20 US institutions, with an overall response rate of 45%. Survey responses indicated that environmental exposures are of concern to clinicians. The vast majority of respondents (88%) reported receiving questions from families about the relationship between certain environmental exposures and the cancers they regularly treat. However, a lack of comfort with these topics seems to have limited their discussions with families about the role of environmental exposures in childhood cancer pathogenesis. Although 77% of respondents suspected that some of the cases they saw had an environmental origin, their methods of taking environmental histories varied widely. Over 90% of respondents believed that more knowledge of the associations between environmental exposures and childhood cancer would be helpful in addressing these issues with patients. Although limited in size and representativeness of participating institutions, the results of this survey indicate a need for increased training for hematology/oncology clinicians about environmental health exposures related to cancer and prompt translation of emerging research findings in biomedical journals that clinicians read.