在未受影响的BRIDGE试验患者中,具有遗传癌症易感性的社会脆弱性和遗传服务利用率
Jemar R Bather1,2, Melody S Goodman3,4, Adrian Harris3
1Center for Anti-Racism, Social Justice & Public Health, New York University School of Global Public Health, 708 Broadway, 9th Floor, New York, NY, 10003, USA. jemar.bather@nyu.edu.
BMC cancer
|January 31, 2025
概括
社会脆弱性影响了遗传癌症风险不影响的个体的基因测试采用. 较高的脆弱性与较低的基因服务启动率和测试完成率相关,突出了针对性干预的需要.
科学领域:
- 遗传学 遗传学 是一个
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 关于影响基因测试吸收的社会决定因素的研究有限,特别是在没有受影响的具有遗传癌症易感性的个体中.
- 扩大遗传服务的覆盖范围,影响和交付 (BRIDGE) 试验调查了遗传服务交付模式.
研究的目的:
- 分析社会脆弱性与基因测试在遗传性癌症易感性未受影响的患者中使用的相关性.
- 为了确定干预类型 (聊天机器人与标准护理) 是否改变了这一关联.
主要方法:
- 在犹他大学卫生和纽约大学朗贡卫生院对2,760名BRIDGE试验参与者的二次分析.
- 利用电子健康记录来衡量遗传咨询和测试的使用率.
- 使用邮政编码构建的人口普查区加权的社会脆弱性指数得分.
- 采用多层次模型来评估社会脆弱性与遗传服务利用之间的关联,对干预适度进行测试.
主要成果:
- 中等社会经济地位 (SES) 弱势地区的患者开始进行测试前遗传服务的几率较低 (aOR=0.81).
- 家庭中等脆弱地区的患者完成预测服务 (aOR=0.80) 和订购遗传测试 (aOR=0.79) 的可能性较低.
- 没有观察到干预条件对社会脆弱性关联的显著缓解.
结论:
- 社会和结构因素对于增加基因测试在高危人群中的普及至关重要.
- 人口普查数据虽然是公开的,但在评估基因测试普及的社会决定因素时却未得到充分利用.
- 未来的队列研究应该整合人口普查数据,以提高对这些差异的理解.
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