确定安全网医院对患乳腺癌高风险患者的服务的需求：缩小差异差距的方法
Defining the Need for Services for Patients at High Risk of Breast Cancer at a Safety-Net Hospital: An Approach to Narrowing the Disparities Gap
影响因子:3.50000
分区:医学2区 / 外科2区 肿瘤学3区
发表日期:2024 Oct
作者:
Olivia Cheng, Caroline Fiser, Jamie Paysour, Ruchi Aluwalia, Aysia Hilliard, Cletus Arciero, Clara R Farley, Jade Jones, Jesse Conyers, Lauren M Postlewait
摘要
最近对国家乳腺癌（NAPBC）标准的国家认证计划进行了修订，以促进乳腺癌（BC）风险评估，并随后转介高危服务。该项目试图估计作者安全网医院系统中卑诗省高风险的患者比例，衡量患者对高危服务的兴趣，并为计划开发定义资源。在2023年2周内，妇女呈现乳房成像的妇女。排除了35例患有病史或诊断的患者。 Tyrer-Cuzick（TC）模型8版用于计算BC风险。高/中级风险定义为10年或以上的10年风险，终身风险为15％或以上，或两者兼而有之。遗传咨询和检测转诊的标准基于国家全面的癌症网络指南。总共257名患者进行了TC风险评估，显示14.8％（n = 38），其10年年的10年风险为5％或更长时间或更长时间（考虑到内分泌治疗）（对内分泌治疗的考虑），有6.2％（= 16），有6.2％（n = 16），有20％或更高的寿命（n = 27％）（n = 27）（n evernensing nifentime nifentime searive nifening Anefening Anefensing A（n）（n evernensing A）（n MRII（MR）（MR）（MR）（MRI）（MRI）（MRI）（MRI）（MRI）（MRI）（MRI）。 BC风险15％或以上（考虑高风险筛查）。在257名患者中，有61例（23.7％）满足了遗传咨询/测试的标准。总体而言，有31.5％（n = 81）有资格获得高/中等风险筛查，降低风险和/或遗传评估/测试，其中92.8％的人对推荐人感兴趣以获取其他信息和护理。大多数患者表示有兴趣寻求此类服务。这些数据将用于财务计划和资源分配中，以根据NAPBC指南在作者机构中制定高风险计划。他们希望这些努力将改善卑诗省社区中的肿瘤学成果和生存。
Abstract
The National Accreditation Program for Breast Cancer (NAPBC) standards were recently revised to promote breast cancer (BC) risk assessment and subsequent referral for high-risk services. This project sought to estimate the proportion of patients at high risk for BC in the authors' safety-net hospital system, gauge patient interest in high-risk services, and define resources for program development.Women presenting for breast imaging during 2 weeks in 2023 were surveyed. Thirty-five patients with a history or diagnosis of BC were excluded. The Tyrer-Cuzick (TC) model version 8 was used to calculate BC risk. High/intermediate risk was defined as a 10-year risk of 5% or more, a lifetime risk of 15% or more, or both. The criteria for genetic counseling and testing referral were based on National Comprehensive Cancer Network guidelines.A total of 257 patients had a TC risk assessment showing 14.8% (n = 38) with a 10-year BC risk of 5% or more (consideration of endocrine therapy), 6.2% (n = 16) with a lifetime BC risk of 20% or more (qualifying for annual screening MRI), and 10.5% (n = 27) with a lifetime BC risk of 15% or more (consideration of high-risk screening). The criteria for genetic counseling/testing were met by 61 (23.7%) of the 257 patients. Overall, 31.5% (n = 81) qualified for high/intermediate-risk screening, risk reduction, and/or genetic assessment/testing, 92.8% of whom were interested in referrals for additional information and care.In the authors' community, almost one third of patients undergoing breast imaging qualify for BC high-risk assessment and services. The majority of the patients expressed interest in pursuing such services. These data will be used in financial planning and resource allocation to develop a high-risk program at the authors' institution in line with NAPBC guidelines. They are hopeful that these efforts will improve oncologic outcomes and survival from BC in their community.