Universal tumor screening for Lynch syndrome: Assessment of the perspectives of patients with colorectal cancer regarding benefits and barriers
Universal tumor screening for Lynch syndrome: Assessment of the perspectives of patients with colorectal cancer regarding benefits and barriers
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DOI：
10.1002/cncr.29470
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发表时间：
2015-09-15
期刊：
影响因子：
6.2
通讯作者：
Goddard, Katrina A. B.
中科院分区：
文献类型：
--
作者：
Hunter, Jessica Ezzell;Zepp, Jamilyn M.;Goddard, Katrina A. B.
背景：Lynch综合征是遗传性结直肠癌（CRC）最常见的一种形式，已被推荐用于所有新诊断为CRC的患者。然而，对于没有根据家族史标准进行筛查的结直肠癌患者，关于Lynch综合征肿瘤筛查的患者观点的文献有限。方法对145例39 ~ 87岁的患者进行调查，评估Lynch综合征肿瘤筛查的感知风险、患者观点、潜在获益和障碍。分析了患者特异性和癌症特异性因素与调查反应之间的关系。结果大多数参与者认为自己患Lynch综合征的风险较低，其中9名参与者（6.2%）预计筛查结果异常。然而，大多数参与者认可筛查对自己和家人的潜在好处，84.8%的人支持6个好处，50.3%的人支持所有8个好处。参与者还认为筛查的潜在障碍很少，89.4%的人赞成9个潜在障碍中的4个。一个常见的障碍是担心额外检测和监测的成本，54.5%的参与者赞同这一点。与Lynch综合征肿瘤筛查相关的痛苦水平非常低，与年龄或CRC分期无关。结论目前的研究结果表明，CRC患者总体上对Lynch综合征的肿瘤筛查持积极态度，认可筛查的益处，并且经历了低水平的痛苦。这些发现揭示了未入选的结直肠癌患者对Lynch综合征肿瘤筛查的态度，为帮助患者决策和指导筛查计划成功实施的教育方法提供了信息。癌症2015;121:3281 - 3289。(c) 2015美国癌症协会。在目前的研究中，评估了新诊断的结直肠癌患者对Lynch综合征的普遍肿瘤筛查的看法。大多数患者似乎对筛查持积极态度，并认可筛查对自己和家人的好处，然而潜在的障碍包括对额外遗传咨询和检测费用的担忧。
BACKGROUNDUniversal tumor screening for Lynch syndrome, the most common form of hereditary colorectal cancer (CRC), has been recommended among all patients newly diagnosed with CRC. However, there is limited literature regarding patient perspectives of tumor screening for Lynch syndrome among patients with CRC who are not selected for screening based on family history criteria.METHODSA total of 145 patients aged 39 to 87 years were administered surveys assessing perceived risk, patient perspectives, and potential benefits of and barriers to tumor screening for Lynch syndrome. Associations between patient-specific and cancer-specific factors and survey responses were analyzed.RESULTSThe majority of participants perceived their risk of developing Lynch syndrome as being low, with 9 participants (6.2%) anticipating an abnormal screening result. However, most participants endorsed the potential benefits of screening for themselves and their families, with 84.8% endorsing 6 benefits and 50.3% endorsing all 8 benefits. Participants also endorsed few potential barriers to screening, with 89.4% endorsing 4 of 9 potential barriers. A common barrier was worry about the cost of additional testing and surveillance, which was endorsed by 54.5% of participants. The level of distress associated with tumor screening for Lynch syndrome, which was very low, was not associated with age or CRC stage.CONCLUSIONSThe results of the current study indicate that patients with CRC overall have a positive attitude toward tumor screening for Lynch syndrome, endorse the benefits of screening, and experience low levels of distress. These findings provide insight into patient attitudes toward tumor screening for Lynch syndrome among unselected patients with CRC to inform educational approaches that assist in patient decision-making and guide the successful implementation of screening programs. Cancer 2015;121:3281-3289. (c) 2015 American Cancer Society.In the current study, perspectives among patients newly diagnosed with colorectal cancer are assessed regarding universal tumor screening for Lynch syndrome. The majority of patients appear to have a positive attitude toward screening and endorse the benefits for themselves and their families, whereas potential barriers include concerns over the cost of additional genetic counseling and testing.