Screening for Ovarian Cancer: Psychobehavioral Outcomes

描述（由申请人提供）：经阴道超声检查 (TVS) 可以促进卵巢癌 (OC) 的早期检测，但是，与所有癌症筛查测试一样，TVS 会产生一定比例的“异常”结果。虽然绝大多数异常 TVS 结果都是良性的，但这种潜在的压力筛查经历对情感、认知和行为结果的影响尚未得到充分研究。拟议的研究以我们当前的研究 (R01 CA84036) 为基础，该研究针对与常规 TVS 筛查相关的心理和行为结果，明确关注异常 TVS 结果的影响。在常规筛查期间收到异常 TVS 结果（异常筛查 (AS) 组）并在四八周后返回进行重复 TVS 测试的女性 (n=400) 将与在常规筛查期间收到正常 TVS 结果的女性 (n=400) 进行匹配（年龄、既往筛查史）（常规筛查 (RS) 组）。所有女性将在常规（RS 组）或重复（AS 组）TVS 筛查之前完成基线评估，并在基线后 1.4 和 18 个月进行后续评估。 AS 组中的一些女性 (n=120) 将在常规 TVS 测试产生异常结果之前完成额外的“真实”基线评估。在基线处获得性格变量（乐观、监控、情绪应对方式）的测量，并且将纵向评估情感（例如，OC 特定的痛苦）、认知（例如，OC 风险认知、TVS 功效信念、益处发现）和行为（例如，OC 特定的监控行为、情绪方式应对、参与乳腺癌/结肠癌筛查）终点。 OC 筛查计划记录将监测对常规 TVS 筛查建议的遵守情况。几种当代应对压力事件的理论模型（认知社会健康信息处理、监测过程、社会认知处理）指导研究变量的选择并提供具体的测试假设。将解决三个具体目标：（1）描述异常 TVS 结果在性质、程度、效价和结果轨迹方面的影响； (2) 确定与这些结果的严重程度和持续性相关的临床、人口统计学、性格和心理社会变量； (3) 制定并试点测试适当的心理教育干预措施，以尽量减少 TVS 结果异常后的负面结果。结果将增强对 OC 筛查异常结果反应的理解，也将增强对其他恶性和非恶性疾病异常筛查结果反应的理解。

DESCRIPTION (provided by applicant): Transvaginal sonography (TVS) can facilitate early detection of ovarian cancer (OC), however, like all cancer screening tests, TVS yields a proportion of "abnormal" findings. While the vast majority of abnormal TVS results are benign, the impact of this potentially stressful screening experience upon affective, cognitive, and behavioral outcomes has not been adequately examined. The proposed research builds on our current study (R01 CA84036) of psychological and behavioral outcomes associated with routine TVS screening by focusing explicitly on the impact of an abnormal TVS result. Women (n=400) receiving an abnormal TVS result during routine screening (Abnormal Screening (AS) group) and returning for a repeat TVS test four-eight weeks later will be matched (age, prior screening history) with women (n=400) receiving a normal TVS result during routine screening (Routine Screening (RS) group). All women will complete a baseline assessment prior to either routine (RS group) or repeat (AS group) TVS screening and follow-up assessments 1,4, and 18 months post-baseline. Some women (n=120) in the AS group will complete an additional "true" baseline assessment prior to the routine TVS test yielding their abnormal result. Measures of dispositional variables (optimism, monitoring, emotional approach coping) are obtained at baseline and affective (e.g., OC-specific distress), cognitive (e.g., OC risk perception, TVS efficacy beliefs, benefit finding), and behavioral (e.g., OC-specific monitoring behavior, emotional approach coping, participation in screening for breast/colon cancers) endpoints will be assessed longitudinally. Adherence with recommendations for routine TVS screening will be monitored by OC screening program records. Several contemporary theoretical models of response to stressful events (Cognitive-Social Health Information Processing, Monitoring Process, Social-Cognitive Processing) guide selection of study variables and provide specific hypotheses for testing. Three specific aims will be addressed: (1) characterize the impact of an abnormal TVS result with regard to the nature, magnitude, valence, and trajectory of outcomes; (2) identify clinical, demographic, dispositional, and psychosocial variables associated with magnitude and persistence of these outcomes; and (3) develop and pilot test an appropriate psycho educational intervention for minimizing negative outcomes after an abnormal TVS result. Results will enhance understanding of response to abnormal results in response to screening for OC and will also enhance understanding of response to abnormal screening results for other malignant and nonmalignant conditions.