Impact of melanoma genetic test reporting on perceived control over melanoma prevention.
Impact of melanoma genetic test reporting on perceived control over melanoma prevention.
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DOI：
10.1007/s10865-015-9631-8
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发表时间：
2015-10
影响因子：
3.1
通讯作者：
Leachman SA
中科院分区：
文献类型：
--
作者：
Aspinwall LG;Stump TK;Taber JM;Kohlmann W;Leaf SL;Leachman SA
为了确定接受黑色素瘤基因检测结果是否会破坏对黑色素瘤预防的感知控制，在接受CDKN 2A/p16检测结果的60名来自黑色素瘤易感家庭的成年人中检查了控制相关信念（27名未受影响的非携带者，15名未受影响的携带者，18名受影响的携带者; 2年的应答率=64.9%的合格受访者）。在2年的时间内，对感知控制评级的多层次建模显示了个体轨迹的显着变化：大多数参与者显示增加（45%）或无变化（38.3%），而16.7%显示下降。在组水平上，非携带者报告在2年随访期间持续增加（ps<.05）;未受影响的携带者报告短期显著增加（ps<.05）;受影响的携带者报告没有变化。所有组的参与者继续认为光保护在降低黑色素瘤风险方面非常有效，并且报告了携带p16突变将不可避免地导致黑色素瘤发展的信念下降。咨询和测试报告后立即进行的定性反应证实了这些发现，93%的人表示有可能预防（64.9%）或降低未来患黑色素瘤的可能性（28.1%）。因此，基因检测报告通常不会破坏对黑色素瘤预防的感知控制，尽管对阳性结果的反应存在变异性，但值得进一步研究。
To determine whether receiving melanoma genetic test results undermines perceived control over melanoma prevention, control-related beliefs were examined among 60 adults from melanoma-prone families receiving CDKN2A/p16 test results (27 unaffected noncarriers, 15 unaffected carriers, 18 affected carriers; response rate at 2 years=64.9% of eligible respondents). Multilevel modeling of perceived control ratings over a 2-year period revealed significant variation in individual trajectories: most participants showed increases (45%) or no change (38.3%), while 16.7% showed decreases. At the group level, noncarriers reported sustained increases through the 2-year follow-up (ps<.05); unaffected carriers reported significant short-term increases (ps<.05); and affected carriers reported no change. Participants in all groups continued to rate photoprotection as highly effective in reducing melanoma risk and reported decreased belief that carrying the p16 mutation would inevitably lead to the development of melanoma. Qualitative responses immediately following counseling and test reporting corroborated these findings, as 93% indicated it was possible to either prevent (64.9%) or decrease the likelihood (28.1%) of future melanomas. Thus, genetic test reporting does not generally undermine perceived control over melanoma prevention, though variability in response to positive results warrants future study.