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Screening adherence in BRCA1/2 families is associated with primary physicians' behavior
Susan T Tinley1, Julia Houfek, Patrice Watson
1Creighton University, Preventive Medicine, Omaha, Nebraska 68178, USA. tinley@creighton.edu
American Journal of Medical Genetics. Part A
|February 3, 2004
Summary
Women at high risk for BRCA1/2 mutations show low adherence to recommended cancer screenings. Primary physician involvement significantly improves screening adherence for these high-risk individuals.
Area of Science:
- Oncology
- Genetics
- Preventive Medicine
Background:
- BRCA1/2 mutations significantly increase breast and ovarian cancer risk.
- Adherence to long-term cancer screening protocols is crucial for early detection in high-risk populations.
Purpose of the Study:
- To assess long-term cancer screening behaviors among women with or at high risk for BRCA1/2 mutations.
- To identify variables associated with screening adherence in this population.
Main Methods:
- A mailed questionnaire assessed screening behaviors, risk perception, distress, and barriers in 112 women (33 mutation carriers, 79 at 50% risk).
- Statistical analyses included descriptive statistics, non-parametric tests, and regression analysis.
Main Results:
- Adherence rates were low for clinical breast exams (21%), breast self-exams (29%), transvaginal ultrasounds (19%), and CA125 screening (1 participant).
- Lack of time, marital status, education, cancer history, provider concern, perceived utility, confidence, distress, and risk perception were associated with adherence.
- Primary physician recommendations and actions were independently associated with adherence to mammography, clinical breast exams, and ultrasounds.
Conclusions:
- Adherence to recommended breast and ovarian cancer screenings is suboptimal in women at high risk for BRCA1/2 mutations.
- Primary physician engagement is essential for improving screening adherence in high-risk patients.