Screening for Ovarian Cancer: Psychobehavioral Outcomes

描述（由申请人提供）：经阴道超声（TVS）可以促进卵巢癌（OC）的早期检测，然而，像所有癌症筛查测试一样，TVS会产生一定比例的“异常”结果。虽然绝大多数异常的TVS结果是良性的，但这种潜在的压力筛选体验对情感、认知和行为结果的影响尚未得到充分的研究。我们提出的研究建立在我们目前的研究（R01 CA84036）的基础上，通过明确关注电视异常结果的影响，研究与常规电视筛查相关的心理和行为结果。在常规筛查（异常筛查（AS）组）中收到异常TVS结果的妇女（n=400），并在4 - 8周后返回进行重复TVS测试，将与在常规筛查（RS）组)中收到正常TVS结果的妇女（n=400）进行匹配（年龄，先前筛查史）。所有女性将在常规（RS组）或重复（AS组）TVS筛查和基线后1、4和18个月随访评估之前完成基线评估。一些AS组的妇女（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、监测、情绪方法应对）的测量，并纵向评估情感（例如，OC特有的痛苦）、认知（例如，OC风险感知、TVS疗效信念、获益发现）和行为（例如，OC特有的监测行为、情绪方法应对、参与乳腺癌/结肠癌筛查）终点。对常规TVS筛查建议的依从性将通过OC筛查项目记录进行监测。当代应激事件反应的几个理论模型（认知-社会健康信息加工、监测过程、社会认知加工）指导了研究变量的选择，并为检验提供了具体的假设。将解决三个具体目标：(1)表征异常TVS结果的影响，包括结果的性质、幅度、价和轨迹；(2)确定与这些结果的强度和持久性相关的临床、人口统计学、性格和社会心理变量；(3)制定和试点适当的心理教育干预措施，以尽量减少电视异常结果后的负面结果。研究结果将增强对异常结果的反应的理解，以及对其他恶性和非恶性疾病异常筛查结果的反应的理解。

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.