在初级保健中实施乳腺癌风险风险风险评估过程
Sarah Tucker Marrison1, Caitlin G Allen2, Kevin Hughes3
1Department of Family Medicine, Medical University of South Carolina, USA.
Journal of cancer prevention & current research
|September 30, 2024
概括
访问前的调查可以在初级保健中确定患乳腺癌的高风险女性. 然而,系统的风险评估和治疗策略需要进一步开发以改善结果.
科学领域:
- 在瘤学瘤学.
- 初级医疗保健医学 一级医疗保健医学
- 预防性健康 预防性健康
背景情况:
- 目前的乳腺癌预防指南强调使用Tyrer-Cuzick和NCCN等工具进行风险评估.
- 高风险女性可能会从早期或额外的查中受益,但在初级保健中不一致的实施导致错过诊断和增加发病率.
- 有效的风险分层对于及时干预和改善患者乳腺癌预防结果至关重要.
研究的目的:
- 评估在初级保健环境中使用预访调查来评估乳腺癌风险的可行性.
- 通过癌症风险评估 (CRA) 工具确定高风险妇女的风险讨论文件和随后的转诊率.
- 探索技术辅助风险评估的潜力,以改善高风险个体的识别和管理.
主要方法:
- 在一个学术初级保健诊所进行了一项单臂干预研究.
- 年龄在25-50岁的妇女接受了使用癌症风险评估 (CRA) 工具的前访问乳腺癌风险评估.
- 数据收集包括访问后的问卷和医疗记录审查,以评估风险讨论和后续行动.
主要成果:
- 调查响应率为24.5%,没有基于种族的显著差异.
- 风险讨论记录在15.4%的病例中,高风险患者 (34.6%) 和平均风险患者 (9.7%) 的风险讨论显著高.
- 在确定的高风险女性中,只有11.4%被转介到高风险乳腺诊所,5.7%被转介到遗传评估中;没有人曾经接受过MRI查或遗传检测.
结论:
- 访问前的调查显示,作为初级保健中乳腺癌风险评估的工具,它是有前途的.
- 系统地实施风险评估和有针对性的干预措施仍然是一个挑战.
- 需要进一步的战略,以确保高风险女性接受适当的查和遗传咨询.
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