一个社区卫生工作者模型,以支持遗传性癌症风险评估和遗传检测
Leah Marsh1, Marlene Mendoza, Zina Tatsugawa
1Department of Obstetrics and Gynecology, Olive View-UCLA Medical Center, and the David Geffen School of Medicine at UCLA and the UCLA Clinical and Translational Science Institute, University of California, Los Angeles, Los Angeles, California; and Corewell Health West, Grand Rapids, Michigan.
Obstetrics and gynecology
|August 3, 2023
概括
一个社区卫生工作者计划显著增加了在服务不足的患者遗传性癌症遗传测试. 这项试点研究表明,对高风险个体的检测有所改善,有助于预防癌症的努力.
科学领域:
- 在瘤学瘤学.
- 遗传学 是一个遗传学.
- 公共卫生 公共卫生
背景情况:
- 遗传性癌症风险评估和遗传检测对于早期检测和预防至关重要.
- 安全网医院为医疗服务不足的人群提供服务,他们经常面临进入专业护理的障碍.
- 社区卫生工作者 (CHW) 可以弥合医疗保健提供方面的差距.
研究的目的:
- 评估CHW支持的遗传性癌症风险评估和遗传检测计划.
- 评估该计划在服务于医疗服务不足患者群体的安全网医院的影响.
- 为了比较项目实施前和之后的基因测试率.
主要方法:
- 一个试点项目利用医疗保健工作者管理基于国家综合癌症网络 (NCCN) 的问卷.
- 高风险患者接受了基于视频的遗传教育,远程医疗结果通知和咨询.
- 基因测试率在计划的前18个月和前18个月之间进行了比较.
主要成果:
- 该CHW计划选了940名患者,确定了196名高风险患者,并对103名患者进行了测试.
- 基因检测在单独基于家族病史的未受影响患者中显著增加 (OR 7.0,P <.001).
- 在CHW计划中,在9.7%的测试患者中发现了致病变体,检测率显著增加 (OR 4.33,P =.051).
结论:
- 使用自主管理问卷和远程医疗的CHW支持的计划在服务不足的环境中是可行的.
- 该计划有效地提高了基于家族病史的高风险,不受影响的患者的检测.
- 这样的举措可以加强遗传性癌症检测和医疗服务不足的人群的癌症预防.
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