PO.PS01.11 · 人群科学
理解关于癌症遗传易感性的观念：HINTS 2020分析
Understanding beliefs about hereditary susceptibility for cancer: An analysis of HINTS 2020
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
目的：癌症由基因和环境之间复杂的相互作用驱动。然而，人们对公众关于癌症遗传易感性观念的了解甚少。本研究在一项具有全国代表性的美国成人调查中刻画了关于癌症遗传易感性的观念。我们还识别了哪些人更可能想知道自己是否具有癌症遗传倾向。程序：我们使用SAS 9.4对NCI健康信息全国趋势调查（HINTS）2020第5周期第4波的数据进行加权调查分析。校正线性回归模型评估以下两项的预测因素：（1）受访者认为遗传基因在多大程度上决定一个人是否会患癌，以及（2）如果受访者具有增加患癌几率的基因改变，他们在多大程度上想知道（这些条目为反向编码）。既往有癌症诊断的个体被排除。结果：大多数受访者（N=3,253）为女性（46.9%）、非西班牙裔白人（57.4%）、已婚（44.4%），平均年龄46.6岁（SE=.58）。平均而言，受访者对遗传易感性在多大程度上决定一个人的癌症风险以及他们想知道自己是否具有癌症遗传倾向的意愿，认同度介于“有些”和“很多”之间。受访者认为癌症（M=1.8，SE=.02）、心血管疾病（M=1.8，SE=.02）和糖尿病（M=1.8，SE=.02）的遗传易感性相似（p均>.6），但认为肥胖的遗传易感性显著更低（M=2.2，SE=.02，p<.0001）。有医疗保险的个体（相对于无保险者，beta = -.42 至 -.37，p = .017 至 .021）以及既往寻求过癌症信息者（beta = -.19，p < .001）更可能相信遗传易感性决定一个人的癌症风险。相信癌症遗传易感性更高的个体更可能想知道自己是否具有癌症遗传倾向（beta = .14，p = .001）。西班牙裔（beta = -.25，p = .0098）和非西班牙裔黑人（beta = -.47，p < .0001）受访者，以及有癌症家族史者（beta = -.20，p = .0051）、既往寻求过癌症信息者（beta = -.19，p = .0019）和宿命论程度较低者（beta = -.08，p = .036），也更可能想了解自己的遗传倾向。结论：相信癌症遗传易感性更高的个体更可能希望在自己具有遗传倾向时被告知。重要的是，西班牙裔和黑人个体比非西班牙裔白人更可能想了解自己的癌症遗传风险，这凸显了克服获取和成本相关障碍、确保公平获得基因检测的迫切需求。需要开展外展和教育工作，以应对宿命论观念以及信息缺乏或错误信息。
查看英文原文 English abstract
Purpose: Cancer is driven by a complex interplay of genes and environment. However, little is known about the public's beliefs about hereditary susceptibility to cancer. This study characterized beliefs about hereditary susceptibility to cancer in a nationally representative survey of US adults. We also identified who is more likely to want to know if they had a genetic predisposition to cancer. Procedures: We analyzed data from the NCI Health Information National Trends Survey (HINTS) 2020 Cycle 5 Wave 4 using SAS 9.4 for weighted survey analysis. Adjusted linear regression models assessed predictors of (1) how much respondents believe genes that are inherited determine whether or not a person will develop cancer and (2) how much respondents would want to know if they had a genetic change that increases their chance of getting cancer (these items were reverse coded). Individuals with a previous cancer diagnosis were excluded. Results: Most respondents (N=3,253) were female (46.9%), non-Hispanic White (57.4%), married (44.4%), and were 46.6 years old (SE=.58). On average, respondents endorsed between “somewhat” and “a lot” for how much hereditary susceptibility determines a person's cancer risk and their desire to know if they had a genetic predisposition to cancer. Respondents believed that hereditary susceptibility to cancer (M=1.8, SE=.02), cardiovascular disease (M=1.8, SE=.02), and diabetes (M=1.8, SE=.02) were similar (p's >.6), but believed hereditary susceptibility to obesity was significantly lower (M=2.2, SE =.02, p<.0001). Individuals with health insurance (versus those who were uninsured, beta = -.42 - -.37, p = .017 - .021) and those who had previously sought cancer information (beta = -.19, p < .001) were more likely to believe that hereditary susceptibility determines a person's cancer risk. Individuals who believe in greater hereditary susceptibility to cancer were more likely to want to know if they had a genetic predisposition to cancer (beta = .14, p = .001). Hispanic (beta = -.25, p = .0098) and non-Hispanic Black (beta = -.47, p < .0001) respondents, and individuals with a family history of cancer (beta = -.20, p = .0051), who previously sought cancer information (beta = -.19, p = .0019), and were less fatalistic (beta = -.08, p = .036) were also more likely to want to know about their genetic predisposition to cancer. Conclusions: Individuals who believe in greater hereditary susceptibility to cancer are more likely to want to be informed if they have a genetic predisposition to cancer. Importantly, Hispanic and Black individuals were more likely than non-Hispanic Whites to want to know about their genetic risk to cancer, which highlights the critical need to overcome barriers related to access and cost and ensure equitable access to genetic testing. Outreach and educational efforts are needed to address fatalistic beliefs and lack of information or misinformation.
利益披露 Disclosure
A. Hatch, None..
N. A. Borja, None.