What does my doctor think?: Preferences for knowing the doctor's opinion among women considering clinical testing for BRCA1/2 mutations
What does my doctor think?: Preferences for knowing the doctor's opinion among women considering clinical testing for BRCA1/2 mutations
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DOI：
10.1089/10906570260199366
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发表时间：
2002-06-01
期刊：
影响因子：
--
通讯作者：
Weber, B
中科院分区：
文献类型：
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作者：
Armstrong, K;Stopfer, J;Weber, B
随着基因检测在临床医学中的迅速发展，传统上强调遗传咨询的非指导性变得越来越有争议。这项研究是为了确定考虑进行BRCA 1/2突变临床检测的妇女是否想知道他们的医疗保健提供者关于他们是否应该接受检测的意见。参与这项研究的是335名妇女，她们在1996年1月至1998年4月期间参加了一所大学的诊所，提供乳腺癌风险评估、遗传咨询和BRCA 1/2检测。共有242名女性（77%）想知道乳腺癌和卵巢癌风险评估项目（BCREP）的医生是否认为她们应该接受检测，28名女性（9%）不确定，46名女性（14%）不想接受BCREP医生对检测的意见。共有158名女性（49%）想知道她们的主治医生是否认为她们应该接受检测，31名女性（10%）不确定，130名女性（41%）不想知道。希望了解BCREP医生的意见与接受BRCA 1/2检测（RR 0.83，95% CI 0.73-0.95）和乳腺癌诊断（RR 0.86，95% CI 0.75-0.99）呈负相关。希望了解他们的主治医生的意见与接受BRCA 1/2检测呈负相关（RR 0.72，95%CI 0.56-0.92）。我们的研究表明，超过四分之三的考虑进行BRCA 1/2突变临床检测的女性想知道癌症遗传学医生的意见，几乎一半的人想知道他们的主治医生对他们是否应该接受检测的意见。这些结果支持遗传咨询模型的使用，允许在患者需要时分享医疗保健提供者的意见。
The traditional emphasis on nondirectiveness in genetic counseling has become increasingly controversial with the rapid expansion of genetic testing in clinical medicine. This study was done to determine whether women considering clinical testing for BRCA1/2 mutations want to know their health care providers' opinions about whether or not they should undergo testing. Participating in the study was a retrospective cohort of 335 women who participated in a university-based clinic offering breast cancer risk assessment, genetic counseling, and BRCA1/2 testing between January, 1996, and April, 1998. A total of 242 women (77%) wanted to know if the doctors at the Breast and Ovarian Cancer Risk Evaluation Program (BCREP) thought they should be tested, 28 women (9%) were unsure, and 46 women (14%) did not want a BCREP doctor's opinion on testing. A total of 158 women (49%) wanted to know if their primary doctor thought they should be tested, 31 women (10%) were unsure, and 130 women (41%) did not want to know. Desire to know the opinion of the BCREP doctors was inversely associated with having undergone BRCA1/2 testing (RR 0.83, 95% CI 0.73-0.95) and having a breast cancer diagnosis (RR 0.86, 95% CI 0.75-0.99). Desire to know their primary doctor's opinion was inversely associated with having undergone BRCA1/2 testing (RR 0.72, 95% CI 0.56-0.92). Our study suggests that over three-quarters of women who considered clinical testing for BRCA1/2 mutations wanted to know the opinions of the cancer genetics doctors and almost half wanted to know their primary doctor's opinion about whether or not they should undergo testing. These results support the use of models of genetic counseling that allow for sharing the health care providers' opinions when desired by the patient.