SCREENING FOR OVARIAN CANCER--PSYCHOBEHAVIORAL OUTCOMES

卵巢癌（OC）的早期发现对于疾病的管理至关重要。虽然经阴道超声检查（TVS）是OC的首选筛查方式，但人们对TVS相关的成本/效益比表示担忧。 虽然TVS已被证明有助于早期发现OC，但TVS产生的"异常"结果比例很高。这些发现需要以重复TVS测试或探查性手术的形式进行额外随访。 虽然这些异常结果中的绝大多数最终被确定为“假阳性”，但这种潜在的压力体验对女性认知、情感和行为的影响尚未得到充分研究。本研究将采用前瞻性、纵向设计，探讨与经阴道超声筛查OC相关的心理和行为结果。 将研究三组女性：接受初始TVS测试并获得正常结果的女性（n = 300），接受初始TVS测试并获得异常结果的女性（n = 300），以及从未接受过TVS测试的健康女性（n = 300）。 将在初始TVS检查前以及2周、4个月、18个月和30个月随访时进行评估。在认知-社会健康信息处理（C-SHIP）和监测过程模型提供的概念框架的指导下，要检查的终点包括认知（例如，风险感知、TVS功效的感知、侵入性和回避性意念），影响（例如，抑郁、情绪障碍）和行为（坚持常规随访TVS测试）。 研究目标包括：（1）对接受TVS筛查的妇女进行表征;（2）识别与TVS筛查相关的心理和行为结果;（3）识别与TVS后心理和行为结果相关的临床、人口统计学和心理变量。 关于后一个目标，关于信息应对方式（例如，高监测）和TVS后的心理和行为结果将进行测试。 研究结果将有助于开发干预措施，以提高经阴道超声筛查OC后的心理和行为结果。

Early detection of ovarian cancer (OC) is critical to management of the disease. While transvaginal sonography (TVS) is the preferred screening modality for OC, concerns have been raised regarding the cost/benefit ratio associated with TVS. While TVS has been shown to facilitate early detection of OC, TVS yields a high proportion of "abnormal" findings. These findings require additional follow-up in the form of repeat TVS testing or exploratory surgery. While the vast majority of these abnormal findings are ultimately determined to be "false positives," the impact of this potentiallly stressful experience upon a woman's cognition, affect, and behavior has not been adequately examined. This study will use a prospective, longitudinal design to examine psychological and behavioral outcomes associated with TVS screening for OC. Three groups of women will be studied: women undergoing an initial TVS test who receive a normal result (n=300), women undergoing an initial TVS test who receive an abnormal result (n=300), and a matched group of healthy women who have never undergone TVS testing (n=300). Assessments will be conducted prior to initial TVS test and at 2 week, and 4, 18, and 30 month followups. Guided by the conceptual framework provided by both the Cognitive-Social Health Information Processing (C-SHIP) and Monitoring Process Models, endpoints to be examined include cognition (e.g., risk perception, perceptions of TVS efficacy, intrusive and avoidant ideation), affect (e.g., depression, mood disturbance), and behavior (adherence to routine follow-up TVS testing). Research aims include: (1) characterization of women who undergo TVS screening; (2) identification of psychological and behavioral outcomes associated with TVS screening; and (3) identification of clinical, demographic, and psychological variables associated with post-TVS psychological and behavioral outcomes. Regarding the latter aim, hypotheses regarding the relationship between informational coping style (e.g., high monitoring) and post-TVS psychological and behavioral outcomes will be tested. Results will enable development of interventions to enhance psychological and behavioral outcomes after TVS screening for OC.