| Autor: |
Yoon S; Health Services and Systems Research, Center for Population Health Research Institute, Duke-NUS Medical School, Singapore Health Services, 8 College Road, Singapore 169857, Singapore., Goh H; Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore., Fung SM; Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore., Tang S; Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore., Matchar D; Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore.; Department of Medicine, Duke University School of Medicine, Durham, NC 27708, USA., Ginsburg GS; Center for Applied Genomics and Precision Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC 27708, USA., Orlando LA; Center for Applied Genomics and Precision Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC 27708, USA., Ngeow J; Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore.; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore., Wu RR; Center for Applied Genomics and Precision Medicine, Department of Medicine, Duke University School of Medicine, 304 Research Dr. Box 90141, Office 264, Durham, NC 27708, USA. |
| Abstrakt: |
A family health history-based risk assessment is particularly valuable for guiding cancer screening and treatment strategies, yet an optimal implementation depends upon end-users' values and needs. This is not only true prior to disease development, but also for those already affected. The aim of this study is to explore perceptions of the value of knowing one's family health history (FHH)-based risk, experience using a patient-facing FHH tool and the potential of the tool for wider implementation. Twenty multi-ethnic Asian patients undergoing breast cancer treatment in Singapore completed an FHH-based risk assessment. Semi-structured one-on-one interviews were conducted and data were thematically analyzed. All participants were female and slightly more than half were Chinese. The acceptance and usage of an FHH risk assessment tool for cancers and its broader implementation was affected by a perceived importance of personal control over early detection, patient concerns of anxiety for themselves and their families due to risk results, concerns for genetic discrimination, adequacy of follow-up care plans and Asian cultural beliefs toward disease and dying. This study uniquely sheds light on the factors affecting Asian breast cancer patients' perceptions about undergoing an FHH-based risk assessment, which should inform steps for a broader implementation in Asian healthcare systems. |
