The Mental Impact of Multicancer Early-Detection Testing скачать в хорошем качестве

The Mental Impact of Multicancer Early-Detection Testing

Prof David Kerr explores the psychological effects of multicancer early-detection tests, examining patient reactions to results. https://www.medscape.com/viewarticle/... -- TRANSCRIPT -- Hello. I'm David Kerr, professor of cancer medicine at the University of Oxford. I wonder if you've ever posed to yourself, or to friends and family — if one had to choose, would one choose whether to discover how one was going to die, or when one was going to die? It splits in two to which of these two parameters they'd like to know about. Think about the psychological impact that knowing one or both of those might have on us. It's not exactly a parallel, but let's consider the psychological impact of these modern, personalized, multicancer early-detection tests. Many of them are in trial, and many of them are based on low copy number in circulating DNA — with some fantastic signs, unquestionably. We don't have any trials that have reported yet on the impact on mortality, or how many lives are saved by these clever early-detection tests. There are enough tests underway for us to start to understand what the psychological impact of these might be. There's a recent publication in Lancet Oncology looking at a cohort of patients in the PATHFINDER study. This is a large, prospective trial based in the United States, where over 6600 patients were recruited to one of these multicancer early-detection tests. Of that large cohort, 1.4%, or 92 patients, had a cancer signal detected. Of those patients, it was a true positive for 35 of them. Nadauld and colleagues attempted to measure the psychological impact of [receiving] a positive or negative cancer signal. They used questionnaires, all of which were well validated, and collected the key elements around depression, anxiety, performance impacts on normal life, and so on. The authors very openly acknowledged the relative weaknesses of their study. Of the 92 patients who had the positive cancer signal, only 50 responded to their questionnaires. As is often the case with prospective quality-of-life studies, there was missing data. I think, statistically, they did their best to overcome it. Despite these small misgivings, the bottom line of their study was pretty positive. They found that multicancer early-detection testing was associated with a high level of satisfaction, so it was welcomed by the screened healthy population. There were small transient increases in anxiety in individuals with a cancer signal detected, so they were of minor concern and resolved within 12 months. I think the other important finding was that the majority of study participants indicated an intention to adhere to future recommended cancer screening. Again, one of the weaknesses of the study was that it wasn't ethnically very mixed. It tended to be more women than men. They tended to be college educated. Therefore, we need to recruit more cohorts from a wider, perhaps more civil society, a representative population. Nevertheless, I posit from this that the psychological impact was relatively small and short-lived rather than it being a sword of Damocles hanging over individuals for all of what life remained. Transcript in its entirety can be found by clicking here: https://www.medscape.com/viewarticle/...