Abstract：
OBJECTIVE: To report the long-term outcomes from a longitudinal psychosocial study that forms part of the \'Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted Screening in men at higher genetic risk and controls\' (IMPACT) study. The IMPACT study is a multi-national study of targeted prostate cancer (PrCa) screening in individuals with a known germline pathogenic variant (GPV) in either the BReast CAncer gene 1 (BRCA1) or the BReast CAncer gene 2 (BRCA2).
METHODS: Participants enrolled in the IMPACT study were invited to complete a psychosocial questionnaire prior to each annual screening visit for a minimum of 5 years. The questionnaire included questions on sociodemographics and the following measures: Hospital Anxiety and Depression Scale, Impact of Event Scale, 36-item Short-Form Health Survey, Memorial Anxiety Scale for PrCa, Cancer Worry Scale, risk perception and knowledge.
RESULTS: A total of 760 participants completed questionnaires: 207 participants with GPV in BRCA1, 265 with GPV in BRCA2 and 288 controls (non-carriers from families with a known GPV). We found no evidence of clinically concerning levels of general or cancer-specific distress or poor health-related quality of life in the cohort as a whole. Individuals in the control group had significantly less worry about PrCa compared with the carriers; however, all mean scores were low and within reported general population norms, where available. BRCA2 carriers with previously high prostate-specific antigen (PSA) levels experience a small but significant increase in PrCa anxiety (P = 0.01) and PSA-specific anxiety (P < 0.001). Cancer risk perceptions reflected information provided during genetic counselling and participants had good levels of knowledge, although this declined over time.
CONCLUSIONS: This is the first study to report the longitudinal psychosocial impact of a targeted PrCa screening programme for BRCA1 and BRCA2 carriers. The results reassure that an annual PSA-based screening programme does not have an adverse impact on psychosocial health or health-related quality of life in these higher-risk individuals. These results are important as more PrCa screening is targeted to higher-risk groups.
METHODS: Participants enrolled in the IMPACT study were invited to complete a psychosocial questionnaire prior to each annual screening visit for a minimum of 5 years. The questionnaire included questions on sociodemographics and the following measures: Hospital Anxiety and Depression Scale, Impact of Event Scale, 36-item Short-Form Health Survey, Memorial Anxiety Scale for PrCa, Cancer Worry Scale, risk perception and knowledge.
RESULTS: A total of 760 participants completed questionnaires: 207 participants with GPV in BRCA1, 265 with GPV in BRCA2 and 288 controls (non-carriers from families with a known GPV). We found no evidence of clinically concerning levels of general or cancer-specific distress or poor health-related quality of life in the cohort as a whole. Individuals in the control group had significantly less worry about PrCa compared with the carriers; however, all mean scores were low and within reported general population norms, where available. BRCA2 carriers with previously high prostate-specific antigen (PSA) levels experience a small but significant increase in PrCa anxiety (P = 0.01) and PSA-specific anxiety (P < 0.001). Cancer risk perceptions reflected information provided during genetic counselling and participants had good levels of knowledge, although this declined over time.
CONCLUSIONS: This is the first study to report the longitudinal psychosocial impact of a targeted PrCa screening programme for BRCA1 and BRCA2 carriers. The results reassure that an annual PSA-based screening programme does not have an adverse impact on psychosocial health or health-related quality of life in these higher-risk individuals. These results are important as more PrCa screening is targeted to higher-risk groups.
摘要：
目的：报告一项纵向社会心理研究的长期结果，该研究构成了“对前列腺癌遗传易感性男性的鉴定：在遗传风险较高的男性中进行有针对性的筛查和对照”（IMPACT）研究的一部分。IMPACT研究是一项针对在BreastCAncer基因1（BRCA1）或BreastCAncer基因2（BRCA2）中具有已知种系致病变异（GPV）的个体中进行靶向前列腺癌（PrCa）筛查的跨国研究。
方法：参加IMPACT研究的参与者被邀请在每次年度筛查访问之前完成心理社会问卷，为期至少5年。问卷包括社会人口统计学问题和以下措施：医院焦虑和抑郁量表，事件规模的影响，36项简式健康调查，PrCa的纪念焦虑量表，癌症忧虑量表，风险感知和知识。
结果：共有760名参与者完成了问卷调查：207名参与者在BRCA1中患有GPV，265名参与者在BRCA2中患有GPV，288名对照（非携带者来自已知GPV的家庭）。我们发现，在整个队列中，没有临床上有关一般或癌症特异性痛苦或不良健康相关生活质量的证据。与携带者相比，对照组的个体对PrCa的担忧明显减少；然而，所有平均得分都很低，在报告的一般人群规范范围内，可用的地方。先前具有较高的前列腺特异性抗原（PSA）水平的BRCA2携带者在PrCa焦虑（P=0.01）和PSA特异性焦虑（P<0.001）方面略有但显着增加。癌症风险认知反映了遗传咨询期间提供的信息，参与者有良好的知识水平，尽管随着时间的推移，这种情况有所下降。
结论：这是首次报道针对BRCA1和BRCA2携带者的有针对性的PrCa筛查计划的纵向社会心理影响的研究。结果保证了每年基于PSA的筛查计划不会对这些高风险个体的社会心理健康或与健康相关的生活质量产生不利影响。这些结果很重要，因为更多的PrCa筛查针对高风险人群。
方法：参加IMPACT研究的参与者被邀请在每次年度筛查访问之前完成心理社会问卷，为期至少5年。问卷包括社会人口统计学问题和以下措施：医院焦虑和抑郁量表，事件规模的影响，36项简式健康调查，PrCa的纪念焦虑量表，癌症忧虑量表，风险感知和知识。
结果：共有760名参与者完成了问卷调查：207名参与者在BRCA1中患有GPV，265名参与者在BRCA2中患有GPV，288名对照（非携带者来自已知GPV的家庭）。我们发现，在整个队列中，没有临床上有关一般或癌症特异性痛苦或不良健康相关生活质量的证据。与携带者相比，对照组的个体对PrCa的担忧明显减少；然而，所有平均得分都很低，在报告的一般人群规范范围内，可用的地方。先前具有较高的前列腺特异性抗原（PSA）水平的BRCA2携带者在PrCa焦虑（P=0.01）和PSA特异性焦虑（P<0.001）方面略有但显着增加。癌症风险认知反映了遗传咨询期间提供的信息，参与者有良好的知识水平，尽管随着时间的推移，这种情况有所下降。
结论：这是首次报道针对BRCA1和BRCA2携带者的有针对性的PrCa筛查计划的纵向社会心理影响的研究。结果保证了每年基于PSA的筛查计划不会对这些高风险个体的社会心理健康或与健康相关的生活质量产生不利影响。这些结果很重要，因为更多的PrCa筛查针对高风险人群。
