Lawrence P. McKinney, Gemechu B Gerbi, Mechelle D. Claridy, B. Rivers
{"title":"摘要:在美国18岁及以上的不同种族和民族的成年人中,与癌症风险相关的遗传信念相关的因素","authors":"Lawrence P. McKinney, Gemechu B Gerbi, Mechelle D. Claridy, B. Rivers","doi":"10.1158/1538-7755.DISP17-B35","DOIUrl":null,"url":null,"abstract":"Background: Recent data suggest a widening gap in the utilization of genetic testing for determining cancer risk among certain racial and ethnic groups in the United States (U.S.). As the availability increases, it remains unclear why minority populations are less likely to engage in genetic testing as compared to non-Hispanic Whites (NHW). It has been postulated that a host of factors may contribute to the disproportionate uptake of genetic testing; however, it remains unclear which factors are most salient for minority populations. The objective of this study was to examine the factors associated with beliefs about genetic testing among a racially and ethnically diverse group of adults in the U.S. Understanding these factors will further our understanding regarding the disparity in the uptake of genetic testing. Methods: Data for this study were obtained from the National Cancer Institute9s 2014 Health Information National Trends Survey (HINTS) Cycle 4, a cross-sectional survey of 2,753 American adults by telephone and postal mail. Bivariate chi-square analyses were conducted to examine the association between each explanatory variable (gender, race/ethnicity, age, level of education, level of income, genetic test knowledge) and the belief that health behaviors (i.e., diet, exercise, and smoking) determine whether a person will develop cancer and the belief that genetics determine whether a person will develop cancer. Multivariable logistic regression analyses were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) to determine whether race, genetic testing knowledge, health behavior beliefs, and sociodemographic factors affect beliefs in cancer genetics risk. Analyses were conducted using SAS version 9.4. Results: After adjusting for socioeconomic status, factors associated with higher odds of reporting that genetics determine whether a person will develop cancer was gender. Women were more than twice as likely to believe that genetics determine whether a person will develop cancer (AOR= 2.20; 95% CI=1.46,3.34). The factors associated with lower odds of reporting that genetics determine whether a person will develop cancer were: African American (AA) (AOR=0.52; 95% CI=0.30,0.89); Hispanic (AOR=0.57;95% CI=0.32,0.99); non-Hispanic Asian (AOR=0.33; 95% CI=0.14,0.79); Other, including Alaska Natives, American Indians, Native Hawaiians, or other Pacific Islanders, and non-Hispanic multiple race (AOR=0.38; 95% CI=0.15,0.95); those with a high school or less than high school education (AOR=0.34; 95% CI=0.19,0.60 and AOR=0.48; 95% CI=0.23-0.99, respectively); those who were age 75 and older (AOR=0.40; 95% CI=0.18,0.88); those earning less than $20,000 income (AOR=0.23; 95% CI=0.09,0.60); and those who believe that health behaviors determine whether a person will develop cancer (AOR=0.08; 95% CI=0.05,0.13). Contrary to our expectations, knowledge of genetic testing was found to be not statistically significant (AOR=0.81; 95% CI=0.50,1.31; p-value=0.39). Conclusion: This study found that individuals not self-identified as non-Hispanic White, individuals over the age of 74, those who did not attain any college education, and individuals who earned less than $20,000 per year were less likely to have the belief that genetic testing can determine whether a person will develop cancer. Future studies are needed to further understand these factors among minority groups in the context of genetic testing. The findings of these studies should inform the development of culturally- , literacy- , and age-appropriate educational materials and targeted community-based cancer risk-communication programs aimed at minority populations to reduce the barriers to genetic testing. Citation Format: Lawrence P. McKinney, Gemechu Gerbi, Mechelle Claridy, Brian Rivers. Factors associated with beliefs about genetics related to cancer risk among racial and ethnic adults 18 years and older in the United States [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B35.","PeriodicalId":254061,"journal":{"name":"Behavioral and Social Science","volume":"22 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Abstract B35: Factors associated with beliefs about genetics related to cancer risk among racial and ethnic adults 18 years and older in the United States\",\"authors\":\"Lawrence P. McKinney, Gemechu B Gerbi, Mechelle D. Claridy, B. Rivers\",\"doi\":\"10.1158/1538-7755.DISP17-B35\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Recent data suggest a widening gap in the utilization of genetic testing for determining cancer risk among certain racial and ethnic groups in the United States (U.S.). As the availability increases, it remains unclear why minority populations are less likely to engage in genetic testing as compared to non-Hispanic Whites (NHW). It has been postulated that a host of factors may contribute to the disproportionate uptake of genetic testing; however, it remains unclear which factors are most salient for minority populations. The objective of this study was to examine the factors associated with beliefs about genetic testing among a racially and ethnically diverse group of adults in the U.S. Understanding these factors will further our understanding regarding the disparity in the uptake of genetic testing. Methods: Data for this study were obtained from the National Cancer Institute9s 2014 Health Information National Trends Survey (HINTS) Cycle 4, a cross-sectional survey of 2,753 American adults by telephone and postal mail. Bivariate chi-square analyses were conducted to examine the association between each explanatory variable (gender, race/ethnicity, age, level of education, level of income, genetic test knowledge) and the belief that health behaviors (i.e., diet, exercise, and smoking) determine whether a person will develop cancer and the belief that genetics determine whether a person will develop cancer. Multivariable logistic regression analyses were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) to determine whether race, genetic testing knowledge, health behavior beliefs, and sociodemographic factors affect beliefs in cancer genetics risk. Analyses were conducted using SAS version 9.4. Results: After adjusting for socioeconomic status, factors associated with higher odds of reporting that genetics determine whether a person will develop cancer was gender. Women were more than twice as likely to believe that genetics determine whether a person will develop cancer (AOR= 2.20; 95% CI=1.46,3.34). The factors associated with lower odds of reporting that genetics determine whether a person will develop cancer were: African American (AA) (AOR=0.52; 95% CI=0.30,0.89); Hispanic (AOR=0.57;95% CI=0.32,0.99); non-Hispanic Asian (AOR=0.33; 95% CI=0.14,0.79); Other, including Alaska Natives, American Indians, Native Hawaiians, or other Pacific Islanders, and non-Hispanic multiple race (AOR=0.38; 95% CI=0.15,0.95); those with a high school or less than high school education (AOR=0.34; 95% CI=0.19,0.60 and AOR=0.48; 95% CI=0.23-0.99, respectively); those who were age 75 and older (AOR=0.40; 95% CI=0.18,0.88); those earning less than $20,000 income (AOR=0.23; 95% CI=0.09,0.60); and those who believe that health behaviors determine whether a person will develop cancer (AOR=0.08; 95% CI=0.05,0.13). Contrary to our expectations, knowledge of genetic testing was found to be not statistically significant (AOR=0.81; 95% CI=0.50,1.31; p-value=0.39). Conclusion: This study found that individuals not self-identified as non-Hispanic White, individuals over the age of 74, those who did not attain any college education, and individuals who earned less than $20,000 per year were less likely to have the belief that genetic testing can determine whether a person will develop cancer. Future studies are needed to further understand these factors among minority groups in the context of genetic testing. The findings of these studies should inform the development of culturally- , literacy- , and age-appropriate educational materials and targeted community-based cancer risk-communication programs aimed at minority populations to reduce the barriers to genetic testing. Citation Format: Lawrence P. McKinney, Gemechu Gerbi, Mechelle Claridy, Brian Rivers. Factors associated with beliefs about genetics related to cancer risk among racial and ethnic adults 18 years and older in the United States [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B35.\",\"PeriodicalId\":254061,\"journal\":{\"name\":\"Behavioral and Social Science\",\"volume\":\"22 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2018-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Behavioral and Social Science\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1158/1538-7755.DISP17-B35\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Behavioral and Social Science","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1158/1538-7755.DISP17-B35","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:最近的数据表明,在美国某些种族和民族群体中,基因检测用于确定癌症风险的使用差距越来越大。随着可用性的增加,与非西班牙裔白人(NHW)相比,为什么少数民族人口不太可能参与基因检测仍不清楚。据推测,许多因素可能导致基因检测的过度使用;然而,目前尚不清楚哪些因素对少数民族人口最为突出。本研究的目的是研究在美国不同种族和民族的成年人群体中,与基因检测信念相关的因素。了解这些因素将进一步加深我们对基因检测接受程度差异的理解。方法:本研究的数据来自美国国家癌症研究所2014年健康信息全国趋势调查(hint)周期4,通过电话和邮政邮件对2753名美国成年人进行横断面调查。进行了双变量卡方分析,以检查每个解释变量(性别、种族/民族、年龄、教育水平、收入水平、基因检测知识)与健康行为(即饮食、运动和吸烟)决定一个人是否会患癌症和基因决定一个人是否会患癌症的信念之间的关联。多变量logistic回归分析用于估计调整优势比(AORs)和95%置信区间(95% ci),以确定种族、基因检测知识、健康行为信念和社会人口因素是否影响癌症遗传风险的信念。采用SAS 9.4版进行分析。结果:在对社会经济地位进行调整后,与基因决定一个人是否患癌症的较高几率相关的因素是性别。女性相信基因决定一个人是否会患癌症的可能性是男性的两倍多(AOR= 2.20;95% CI = 1.46, 3.34)。报告基因决定一个人是否会患癌症的几率较低的相关因素有:非裔美国人(AOR=0.52);95% CI = 0.30, 0.89);西班牙裔(AOR=0.57;95% CI=0.32,0.99);非西班牙裔亚洲人(AOR=0.33;95% CI = 0.14, 0.79);其他,包括阿拉斯加原住民、美洲印第安人、夏威夷原住民或其他太平洋岛民,以及非西班牙裔多种族(AOR=0.38;95% CI = 0.15, 0.95);高中及以下学历者(AOR=0.34);95% CI=0.19,0.60, AOR=0.48;95% CI=0.23-0.99);75岁及以上(AOR=0.40;95% CI = 0.18, 0.88);收入少于$20,000的人士(AOR=0.23);95% CI = 0.09, 0.60);认为健康行为决定一个人是否会患癌症的人(AOR=0.08;95% CI = 0.05, 0.13)。与我们的预期相反,发现基因检测知识没有统计学意义(AOR=0.81;95% CI = 0.50, 1.31;假定值= 0.39)。结论:这项研究发现,不认为自己是非西班牙裔白人的人、年龄超过74岁的人、没有接受过任何大学教育的人、年收入低于2万美元的人不太可能相信基因检测可以确定一个人是否会患癌症。未来的研究需要在基因检测的背景下进一步了解少数群体中的这些因素。这些研究的发现应该为文化、文化和年龄相适应的教育材料的发展提供信息,并为针对少数民族人群的有针对性的社区癌症风险交流计划提供信息,以减少基因检测的障碍。引文格式:Lawrence P. McKinney, Gemechu Gerbi, Mechelle Claridy, Brian Rivers。在美国18岁及以上的不同种族和民族的成年人中,与癌症风险相关的基因信念相关的因素[摘要]。见:第十届AACR会议论文集:种族/少数民族和医疗服务不足人群的癌症健康差异科学;2017年9月25-28日;亚特兰大,乔治亚州。费城(PA): AACR;癌症流行病学杂志,2018;27(7增刊):摘要nr B35。
Abstract B35: Factors associated with beliefs about genetics related to cancer risk among racial and ethnic adults 18 years and older in the United States
Background: Recent data suggest a widening gap in the utilization of genetic testing for determining cancer risk among certain racial and ethnic groups in the United States (U.S.). As the availability increases, it remains unclear why minority populations are less likely to engage in genetic testing as compared to non-Hispanic Whites (NHW). It has been postulated that a host of factors may contribute to the disproportionate uptake of genetic testing; however, it remains unclear which factors are most salient for minority populations. The objective of this study was to examine the factors associated with beliefs about genetic testing among a racially and ethnically diverse group of adults in the U.S. Understanding these factors will further our understanding regarding the disparity in the uptake of genetic testing. Methods: Data for this study were obtained from the National Cancer Institute9s 2014 Health Information National Trends Survey (HINTS) Cycle 4, a cross-sectional survey of 2,753 American adults by telephone and postal mail. Bivariate chi-square analyses were conducted to examine the association between each explanatory variable (gender, race/ethnicity, age, level of education, level of income, genetic test knowledge) and the belief that health behaviors (i.e., diet, exercise, and smoking) determine whether a person will develop cancer and the belief that genetics determine whether a person will develop cancer. Multivariable logistic regression analyses were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) to determine whether race, genetic testing knowledge, health behavior beliefs, and sociodemographic factors affect beliefs in cancer genetics risk. Analyses were conducted using SAS version 9.4. Results: After adjusting for socioeconomic status, factors associated with higher odds of reporting that genetics determine whether a person will develop cancer was gender. Women were more than twice as likely to believe that genetics determine whether a person will develop cancer (AOR= 2.20; 95% CI=1.46,3.34). The factors associated with lower odds of reporting that genetics determine whether a person will develop cancer were: African American (AA) (AOR=0.52; 95% CI=0.30,0.89); Hispanic (AOR=0.57;95% CI=0.32,0.99); non-Hispanic Asian (AOR=0.33; 95% CI=0.14,0.79); Other, including Alaska Natives, American Indians, Native Hawaiians, or other Pacific Islanders, and non-Hispanic multiple race (AOR=0.38; 95% CI=0.15,0.95); those with a high school or less than high school education (AOR=0.34; 95% CI=0.19,0.60 and AOR=0.48; 95% CI=0.23-0.99, respectively); those who were age 75 and older (AOR=0.40; 95% CI=0.18,0.88); those earning less than $20,000 income (AOR=0.23; 95% CI=0.09,0.60); and those who believe that health behaviors determine whether a person will develop cancer (AOR=0.08; 95% CI=0.05,0.13). Contrary to our expectations, knowledge of genetic testing was found to be not statistically significant (AOR=0.81; 95% CI=0.50,1.31; p-value=0.39). Conclusion: This study found that individuals not self-identified as non-Hispanic White, individuals over the age of 74, those who did not attain any college education, and individuals who earned less than $20,000 per year were less likely to have the belief that genetic testing can determine whether a person will develop cancer. Future studies are needed to further understand these factors among minority groups in the context of genetic testing. The findings of these studies should inform the development of culturally- , literacy- , and age-appropriate educational materials and targeted community-based cancer risk-communication programs aimed at minority populations to reduce the barriers to genetic testing. Citation Format: Lawrence P. McKinney, Gemechu Gerbi, Mechelle Claridy, Brian Rivers. Factors associated with beliefs about genetics related to cancer risk among racial and ethnic adults 18 years and older in the United States [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B35.