Screening for Ovarian Cancer: Psychobehavioral Outcomes

描述(申请人提供)：经阴道超声检查(TVS)可以帮助早期发现卵巢癌(OC)，但像所有癌症筛查测试一样，TVS会产生一定比例的“异常”发现。虽然绝大多数异常电视检查结果是良性的，但这种潜在的应激筛查经验对情感、认知和行为结果的影响尚未得到充分研究。拟议的研究建立在我们目前的研究(R01 CA84036)的基础上，通过明确关注异常电视结果的影响，与常规电视筛查相关的心理和行为结果。400名妇女(n=400)在常规筛查期间TVS结果异常(AS组)，并在4-8周后返回进行重复TVS测试，将匹配(年龄、既往筛查病史)与在常规筛查(RS组)期间TVS结果正常的妇女(n=400)。所有女性都将在常规(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个月进行随访评估。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。性格变量(乐观、监控、情绪应对)的测量是在基线和情感(例如，OC特有的痛苦)、认知(例如，OC风险感知、电视VS疗效信念、受益发现)和行为(例如，OC特有的监测行为、情绪应对、参与乳腺癌/结肠癌筛查)终点获得的，将进行纵向评估。遵守常规电视筛查建议的情况将通过OC筛查计划记录进行监控。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、监控过程、社会-认知加工)指导研究变量的选择，并为检验提供具体的假设。将涉及三个具体目标：(1)从结果的性质、大小、效价和轨迹来描述异常电视结果的影响；(2)确定与这些结果的大小和持续性相关的临床、人口、性格和心理社会变量；以及(3)开发和试点适当的心理教育干预措施，以最大限度地减少异常电视结果后的负面结果。结果将增强对OC筛查异常结果的反应的理解，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.