A Patient-Centered Approach to Counseling Patients With Head and Neck Cancer Undergoing Human Papilloma virus Testing: A Clinician's Guide
A Patient-Centered Approach to Counseling Patients With Head and Neck Cancer Undergoing Human Papilloma virus Testing: A Clinician's Guide
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DOI：
10.1634/theoncologist.2012-0200
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发表时间：
2013-02-01
期刊：
影响因子：
5.8
通讯作者：
Sikora, Andrew
中科院分区：
文献类型：
--
作者：
Chu, Amy;Genden, Eric;Sikora, Andrew
国际癌症研究机构和国家癌症研究所已经承认人乳头瘤病毒(HPV)-16是口咽癌（OPC）的独立危险因素。hpv阳性口咽癌（HPVOPC）是一种呈上升趋势的性传播疾病；在未来10年内，预计每年hpv相关的OPC病例数将超过美国每年宫颈癌病例数。在OPC中识别HPV状态具有广泛的意义，超出了及时诊断，准确分期和适当治疗癌症患者的传统肿瘤学关注点。国家综合癌症网络建议在OPC管理期间检测肿瘤部位的hpv状态；这很可能会成为高概率口咽肿瘤患者护理的标准组成部分。随着HPV检测的实践变得越来越普遍，提供者应该能够充分解决HPVOPC患者的担忧。尽管目前针对这一人群的相关研究很少，但现有的关于hpv感染妇女和宫颈癌患者的文献强烈支持这样的观点，即hpv患者需要接受教育，以最佳地解决自责、内疚、亲密关系和人际关系等问题。在进行HPV检测时，应辅以循证和以患者为中心的咨询，以最大限度地减少负面的社会心理后果，并确保最佳的健康促进。基于目前的文献状况，本文旨在为医生在诊断hpv相关OPC患者时有效管理心理社会结局提供参考。肿瘤学家2013；18:180 - 189
The International Agency for Research on Cancer and the National Cancer Institute have acknowledged human papillomavirus (HPV)-16 as an independent risk factor for oropharyngeal cancer (OPC). HPV-positive oropharyngeal cancer (HPVOPC) is a sexually transmitted entity that is on the rise; within the next 10 years, the annual number of HPV-associated OPC cases is projected to exceed the annual number of cervical cancer cases in the United States. Recognition of HPV status in OPC has broad implications beyond the traditional oncological concerns of timely diagnosis, accurate staging, and appropriate treatment of cancer patients. The National Comprehensive Cancer Network recommends testing the tumor site for HPV-status during OPC management; it is likely this will become a standard component of care for patients with high-probability tumors of the oropharynx. As the practice of HPV testing becomes more common, it behooves providers to be able to adequately address the concerns of patients with HPVOPC. Although there are currently few relevant studies focusing on this population, existing literature on HPV-infected women and patients with cervical cancer strongly supports the concept that patients with HPVOPC need education to optimally address concerns such as self-blame, guilt, intimacy, and interpersonal relationships. When HPV testing is done, it should be accompanied by evidence-driven and patient-centered counseling to best minimize negative psychosocial outcomes and ensure optimum health promotion. Based on the current state of the literature, this article is intended to be a reference for physicians to effectively manage psychosocial outcomes when diagnosing patients with HPV-associated OPC. The Oncologist 2013;18:180-189