cancer risk assessment

癌症风险评估
  • 文章类型: Journal Article
    人类消费水质监测信息系统(SISáGUA)旨在管理人类消费的水污染风险。这篇简短的交流侧重于2022年报告中有关农药分析的数据。在饮用水样品中发现的27种活性农药成分超过巴西立法规定的最大残留限量(MRL)的数据中心。结果表明,1609个城市(60%)在其水中发现了至少一种农药。二百十个城市检测到所有27种杀虫剂,据报道,这些农药中有11种具有致癌潜力。近150万人暴露于巴西MRL以上的水平,检测到的最大残留物总和超过80,000ppb。此外,该报告强调,53%的巴西城市没有提交人类消费的水监测数据。因此,在SISáGUA框架内改进和扩大水分析的范围至关重要。
    The Water Quality Surveillance Information System for Human Consumption (SISÁGUA) is designed to manage the risks of water contamination for human consumption. This short communication focuses on data from the 2022 Report regarding pesticide analysis. The data centers on 27 active pesticide ingredients found in drinking water samples exceeding the maximum residual limits (MRLs) established by Brazilian legislation. Results indicate that 1609 municipalities (60 %) found at least one pesticide in their water. Two hundred ten municipalities detected all 27 pesticides tested, with 11 of these pesticides reported to have some carcinogenic potential. Nearly one and a half million people were exposed to levels above the Brazilian MRL, with the sum of maximum detected residues exceeding 80,000 ppb. Additionally, the report highlights that 53 % of Brazilian municipalities did not submit water monitoring data for human consumption. Thus, improving and expanding the scope of water analysis within the SISÁGUA framework is essential.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    空气污染是具有不同生物活性的复杂环境混合物的一个例子,使风险评估具有挑战性。当前的癌症风险评估策略侧重于单个污染物可能忽略了它们之间的相互作用。可能低估健康风险。因此,转向评估整体混合物对于准确的风险评估至关重要。这项研究提出了一种体外新方法方法(NAM)的应用,以估计整个混合物的相对癌症效力因子。重点关注与空气颗粒物(PM)相关的有机污染物。使用DNA损伤信号蛋白检查点激酶1(pChk1)的浓度依赖性激活作为读数,我们比较了两种建模方法,希尔方程和基准剂量(BMD)方法,推导混合效价因子(MPF)。确定了覆盖不同土地利用地点的五个PM2.5样品的MPF,以及我们的PM10样品和标准参考材料的历史pChk1数据。我们的结果表明,与参考化合物苯并[a]芘相比,所有样品的pChk1浓度依赖性增加,并且效力更高。从Hill方程得出的MPF范围为128至9793,而从BMD建模得出的MPF范围为70至303。尽管大小不同,观察到相对效力的一致性。值得注意的是,来自受生物质燃烧强烈影响的地点的PM2.5样品具有最高的MPF。尽管在整个混合物样品的两种建模方法之间观察到差异,单个PAHs的相对效价因子更为一致。我们得出的结论是,浓度响应曲线形状的差异以及MPF的推导方式解释了复杂混合物和单个PAHs模型一致性的观察差异。这项研究有助于预测毒理学的发展,并强调了从评估单个试剂过渡到完整混合物评估以进行准确的癌症风险评估和公共卫生保护的可行性。
    Air pollution is an example of a complex environmental mixture with different biological activities, making risk assessment challenging. Current cancer risk assessment strategies that focus on individual pollutants may overlook interactions among them, potentially underestimating health risks. Therefore, a shift towards the evaluation of whole mixtures is essential for accurate risk assessment. This study presents the application of an in vitro New Approach Methodology (NAM) to estimate relative cancer potency factors of whole mixtures, with a focus on organic pollutants associated with air particulate matter (PM). Using concentration-dependent activation of the DNA damage-signaling protein checkpoint kinase 1 (pChk1) as a readout, we compared two modeling approaches, the Hill equation and the benchmark dose (BMD) method, to derive Mixture Potency Factors (MPFs). MPFs were determined for five PM2.5 samples covering sites with different land uses and our historical pChk1 data for PM10 samples and Standard Reference Materials. Our results showed a concentration-dependent increase in pChk1 by all samples and a higher potency compared to the reference compound benzo[a]pyrene. The MPFs derived from the Hill equation ranged from 128 to 9793, while those from BMD modeling ranged from 70 to 303. Despite the differences in magnitude, a consistency in the relative order of potencies was observed. Notably, PM2.5 samples from sites strongly impacted by biomass burning had the highest MPFs. Although discrepancies were observed between the two modeling approaches for whole mixture samples, relative potency factors for individual PAHs were more consistent. We conclude that differences in the shape of the concentration-response curves and how MPFs are derived explain the observed differences in model agreement for complex mixtures and individual PAHs. This research contributes to the advancement of predictive toxicology and highlights the feasibility of transitioning from assessing individual agents to whole mixture assessment for accurate cancer risk assessment and public health protection.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    本文重新评估了X射线诱导的体细胞基因突变的首次报道。它是由约翰·帕特森承担的,HermannMuller系主任,使用相同的生物模型,穆勒的方法和设备。Patterson报道了X射线诱导的黑腹果蝇体细胞中X染色体连锁(性别连锁)隐性基因突变的突变频率,导致眼睛的眼虫颜色变化。结果基于在卵中照射的雄性和雌性后代中检测到的颜色变化,幼虫或p期,用于未照射的对照。Patterson声称观察到的剂量反应显示出线性,清楚地表明,线性响应扩展到未辐照对照的背景暴露水平。这种重新分析质疑帕特森的解释,表明低剂量区的剂量反应强烈支持阈值模型。实验中的剂量,没有清楚地呈现,如此之高,以至于无法假设该实验提供了与低剂量人类辐射暴露相关的任何信息,甚至以低剂量率递送高剂量。在较高剂量下发生的诱导表型变化,尤其是在雌性后代中,绝大多数是由X射线诱导的染色体断裂而不是Patterson最初预期的点突变引起的。Patterson的发现和线性解释是在概念整合形成期间接受线性非阈值(LNT)模型的重要促成因素。现在看到实际数据不支持LNT模型是相当令人震惊的。
    This paper reevaluates the first report of X-ray-induced somatic gene mutations. It was undertaken by John Patterson, Department Chair of Hermann Muller, using the same biological model, methods and equipment of Muller. Patterson reported X-ray induced mutation frequencies for X-chromosome-linked (sex-linked) recessive gene mutations in somatic cells of Drosophila melanogaster that resulted in color changes in the ommatidia of the eyes. Results were based on color changes detected in both male and female offspring irradiated while in egg, larval or pupal stages and for unirradiated controls. Patterson claimed that the observed dose response displayed linearity, with a clear implication that the linear response extended to background exposure levels of unirradiated controls. This reanalysis disputes Patterson\'s interpretation, showing that the dose response in the low-dose zone strongly supported a threshold model. The doses in the experiment, which were not clearly presented, were so high that it would preclude the assumption that the experiment provided any information of relevance to radiation exposures of humans at low doses, or even at high doses delivered at low-dose rates. Induced phenotypical changes that occurred at the higher doses, especially in female offspring, overwhelmingly resulted from X-ray-induced chromosome breaks instead of point mutations as initially expected by Patterson. The Patterson findings and linearity interpretations were an important contributory factor in the acceptance of the linear non-threshold (LNT) model during the formative time of concept consolidation. It is rather shocking now to see that the actual data provided no support for the LNT model.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    长期暴露于室内挥发性有机化合物(VOCs)可导致多种不良反应,包括癌症。我们审查了2010年至2023年期间发布的欧盟(EU)成员国办公室以及住宅和教育建筑中挥发性有机化合物水平的报告。我们使用这些数据来评估人口健康的风险,通过估计终身暴露于室内VOC和由此产生的非癌症和癌症风险,由此,可归因于VOC暴露和相关经济损失的癌症负担。我们的系统审查确定了1783篇文章,其中184项进行了详细检查,58个产生相关数据。在分别合并欧盟国家和建筑类型的VOC浓度数据后,我们使用概率蒙特卡罗模拟以风险商和终生超额癌症风险(LECR)评估了非癌症和癌症风险.LECR用于估计VOC相关癌症的残疾调整寿命年(DALYs)和相关成本。我们发现,在法国和德国,与甲醛接触相关的LECR高于可接受的风险水平(ARL),而在西班牙女性中,与苯接触的LECR也高于ARL。暴露于乙醛的DALYs和相关成本之和/1,000,000人口/年,苯,甲醛,四氯乙烯,和三氯乙烯分别为4.02和41,010欧元,在法国,那些暴露于乙醛的人,苯,四氯化碳,甲醛,三氯乙烯在德国分别为3.91和39,590欧元,在西班牙,暴露于苯的比例为0.1和1030欧元。作为一个整体,这些发现表明,室内暴露于VOCs仍然是欧盟的公共卫生问题。尽管欧盟对某些挥发性有机化合物设定了限制,需要采取进一步措施限制这些化学品在消费品中的使用。
    Chronic exposure to indoor volatile organic compounds (VOCs) can result in several adverse effects including cancers. We review reports of levels of VOCs in offices and in residential and educational buildings in the member states of the European Union (EU) published between 2010 and 2023. We use these data to assess the risk to population health by estimating lifetime exposure to indoor VOCs and resulting non-cancer and cancer risks and, from that, the burden of cancer attributable to VOC exposure and associated economic losses. Our systematic review identified 1783 articles, of which 184 were examined in detail, with 58 yielding relevant data. After combining data on VOC concentrations separately for EU countries and building types, non-cancer and cancer risks were assessed in terms of hazard quotient and lifetime excess cancer risk (LECR) using probabilistic Monte Carlo Simulations. The LECR was used to estimate disability adjusted life years (DALYs) from VOC-related cancers and associated costs. We find that the LECR associated with formaldehyde exposure was above the acceptable risk level (ARL) in France and Germany and that of from exposure to benzene was also above the ARL in Spanish females. The sum of DALYs and related costs/1,000,000 population/year from exposure to acetaldehyde, benzene, formaldehyde, tetrachloroethylene, and trichloroethylene were 4.02 and €41,010, respectively, in France, those from exposure to acetaldehyde, benzene, carbon tetrachloride, formaldehyde, and trichloroethylene were 3.91 and €39,590 in Germany, and those from exposure to benzene were 0.1 and €1030 in Spain. Taken as a whole, these findings show that indoor exposure to VOCs remains a public health concern in the EU. Although the EU has set limits for certain VOCs, further measures are needed to restrict the use of these chemicals in consumer products.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    Lorcaserin是5-羟色胺2C(5-羟色胺)受体激动剂和非遗传毒性大鼠致癌物,在为期两年的生物测定中,在雄性和雌性大鼠中诱导了乳腺肿瘤。雌性SpragueDawley大鼠每天用0、30或100mg/kg的氯卡色林进行灌胃治疗,复制生物测定给药,但持续时间较短,12或24周。为了表征暴露并消除潜在基因毒性降解产物的可能混淆,lorcaserinandN-nitroso-lorcaserinwerequantifiedindosingsolutions,终端血浆,乳腺和肝脏样品使用超高效液相色谱-电喷雾串联质谱。没有检测到N-亚硝基-lorcaserin,支持将lorcaserin分类为非遗传毒性致癌物。乳腺DNA样品(n=6/剂量/时间点)用于从包含热点癌症驱动突变(CDMs)的基因片段合成PCR产物,即Apc的区域,Braf,Egfr,Hras,Kras,Nfe2l2,Pik3ca,Setbp1、Stk11和Tp53。通过CarcSeq定量扩增子中的突变级分(MF),错误校正的下一代测序方法。考虑到所有恢复的突变体,lorcaserin剂量组之间没有观察到显著差异。然而,在两个时间点均观察到Pik3caH1047R突变的显着剂量反应性增加(ANOVA,p<0.05),与12周相比,在24周观察到更多数量的突变体和具有更大MF的突变体。这些观察结果表明,lorcaserin促进自发发生的Pik3caH1047R突变克隆的生长,从而导致乳腺癌发生。重要的是,这项工作报告了分析克隆扩增的方法,并证明了使用短至3个月的治疗时间检测非基因毒性致癌物质的致癌影响(选择性Pik3caH0147R突变体扩增)。
    Lorcaserin is a 5-hydroxytryptamine 2C (serotonin) receptor agonist and a non-genotoxic rat carcinogen, which induced mammary tumors in male and female rats in a two-year bioassay. Female Sprague Dawley rats were treated by gavage daily with 0, 30, or 100 mg/kg lorcaserin, replicating bioassay dosing but for shorter duration, 12 or 24 weeks. To characterize exposure and eliminate possible confounding by a potentially genotoxic degradation product, lorcaserin and N-nitroso-lorcaserin were quantified in dosing solutions, terminal plasma, mammary and liver samples using ultra high-performance liquid chromatography-electrospray tandem mass spectrometry. N-nitroso-lorcaserin was not detected, supporting lorcaserin classification as non-genotoxic carcinogen. Mammary DNA samples (n = 6/dose/timepoint) were used to synthesize PCR products from gene segments encompassing hotspot cancer driver mutations (CDMs), namely regions of Apc, Braf, Egfr, Hras, Kras, Nfe2l2, Pik3ca, Setbp1, Stk11, and Tp53. Mutant fractions (MFs) in the amplicons were quantified by CarcSeq, an error corrected next-generation sequencing approach. Considering all recovered mutants, no significant differences between lorcaserin dose groups were observed. However, significant dose-responsive increases in Pik3ca H1047R mutation were observed at both timepoints (ANOVA, p < 0.05), with greater numbers of mutants and mutants with greater MFs observed at 24 weeks as compared to 12 weeks. These observations suggest lorcaserin promotes outgrowth of spontaneously occurring Pik3ca H1047R mutant clones leading to mammary carcinogenesis. Importantly, this work reports approaches to analyze clonal expansion and demonstrates CarcSeq detection of the carcinogenic impact (selective Pik3ca H0147R mutant expansion) of a non-genotoxic carcinogen using a treatment duration as short as 3 months.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    挥发性有机化合物,比如BTEX,由于它们对环境和人类健康的有害影响,已经成为许多辩论的主题。人类在这种情况的出现中发挥了重要作用。尽管美国环保署,WHO,和其他与健康有关的组织已将标准限值设定为不危险水平,据观察,在这些限度内甚至低于这些限度,不断接触这些有毒化学物质也会导致负面后果。根据这些事实,世界各地已经进行了各种研究-其中160个是在这篇综述文章中收集的,以便专家和州长可以提出有效的解决方案来管理和控制这些有毒化学物质。这项研究的结果将为社会评估和处理暴露于BTEX的风险服务。在这篇评论文章中,尝试收集与大气中BTEX风险评估相关的最容易获得的研究,为了让文章包含最小的偏见,所有作者都对其进行了审查和重新评估,他们来自不同的机构和背景,以便文章的见解保持公正。由于原始来源,在某些方面的一致性或精确性可能存在一些限制,然而,尝试是尽可能地最小化它们。
    Volatile organic compounds, such as BTEX, have been the subject of numerous debates due to their detrimental effects on the environment and human health. Human beings have had a significant role in the emergence of this situation. Even though US EPA, WHO, and other health-related organizations have set standard limits as unhazardous levels, it has been observed that within or even below these limits, constant exposure to these toxic chemicals results in negative consequences as well. According to these facts, various studies have been carried out all over the world - 160 of which are collected within this review article, so that experts and governors may come up with effective solutions to manage and control these toxic chemicals. The outcome of this study will serve the society to evaluate and handle the risks of being exposed to BTEX. In this review article, the attempt was to collect the most accessible studies relevant to risk assessment of BTEX in the atmosphere, and for the article to contain least bias, it was reviewed and re-evaluated by all authors, who are from different institutions and backgrounds, so that the insights of the article remain unbiased. There may be some limitations to consistency or precision in some points due to the original sources, however the attempt was to minimize them as much as possible.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    1931年,赫尔曼·J·穆勒的博士后,乔治·D·斯内尔(诺贝尔奖获得者-1980年)发起了一项研究,用小鼠复制穆勒的X射线诱导的果蝇突变发现。Snell未能诱导两种感兴趣的突变,基于苍蝇数据(性别相关致死性/隐性可见突变),即使研究设计良好,使用大剂量的X射线,并发表在《遗传学》杂志上。这些发现从未被穆勒引用过,和斯内尔纸(斯内尔,遗传学20:545-567,1935年)没有引用1927年的穆勒论文(穆勒,科学66:84,1927)。这种情况引发了有关Snell如何撰写论文的问题(例如,忽略了不为穆勒在哺乳动物中的发现提供支持的重要性)。可能会提出一个问题,即是否对Snell施加了专业压力,以淡化他的发现的重要性,这可能会对穆勒的职业生涯和LNT理论产生负面影响。虽然穆勒会受到全世界的关注,并在1946年获得诺贝尔奖,“因为发现X射线可以诱导突变,Snell的阴性突变数据几乎完全被他的当代和随后的辐射遗传学/突变研究人员所忽视。这引发了关于Snell的负面发现的明显缺乏兴趣如何帮助穆勒专业的问题,包括他成功利用果蝇数据影响遗传和癌症风险评估并获得诺贝尔奖。
    In 1931, Hermann J. Muller\'s postdoctoral student, George D. Snell (Nobel Prize recipient--1980) initiated research to replicate with mice Muller\'s X-ray-induced mutational findings with fruit flies. Snell failed to induce the two types of mutations of interest, based on fly data (sex-linked lethals/recessive visible mutations) even though the study was well designed, used large doses of X-rays, and was published in Genetics. These findings were never cited by Muller, and the Snell paper (Snell, Genetics 20:545-567, 1935) did not cite the 1927 Muller paper (Muller, Science 66:84, 1927). This situation raises questions concerning how Snell wrote the paper (e.g., ignoring the significance of not providing support for Muller\'s findings in a mammal). The question may be raised whether professional pressures were placed upon Snell to downplay the significance of his findings, which could have negatively impacted the career of Muller and the LNT theory. While Muller would receive worldwide attention, and receive the Nobel Prize in 1946 \"for the discovery that mutations can be induced by X-rays,\" Snell\'s negative mutation data were almost entirely ignored by his contemporary and subsequent radiation genetics/mutation researchers. This raises questions concerning how the apparent lack of interest in Snell\'s negative findings helped Muller professionally, including his success in using his fruit fly data to influence hereditary and cancer risk assessment and to obtain the Nobel Prize.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    国际癌症研究机构(IARC)于2012年提出了使用关键特征方法对机械证据进行系统审查和评估,并自2015年以来由IARC专著工作组使用。关键特征是已知导致人类癌症的试剂的十个特征。从2015年到2022年,共有19种专著(73种药物组合)使用了关键特征进行癌症风险分类。我们假设,使用不同药物的异质性机理数据对关键特征方法在癌症危险分类中的应用进行回顾性分析将为决策中的系统评价提供信息。我们提取了结论的信息,数据类型,以及机制数据在每个专著的癌症风险分类中的作用。统计分析确定了关键特征使用的模式,以及关键特征之间的趋势和相关性,数据类型,和最终的决定。尽管许多代理人和关键特征的数据存在差距,出现了几个重要的结果。来自体内动物的机制数据,体外动物和体外人体研究对于得出结论认为药物可以通过关键特征引起癌症最有影响力。为了排除关键特征的参与,来自诸如ToxCast之类的大规模系统体外测试程序的数据是最有益的。总的来说,增加系统化数据流的可用性,例如人体体外数据,将为有关正面和负面关联的可靠结论提供基础,并构成专家判断中各种权重来源的相对贡献。
    Systematic review and evaluation of mechanistic evidence using the Key Characteristics approach was proposed by the International Agency for Research on Cancer (IARC) in 2012 and used by the IARC Monographs Working Groups since 2015. Key Characteristics are 10 features of agents known to cause cancer in humans. From 2015 to 2022, a total of 19 Monographs (73 agents combined) used Key Characteristics for cancer hazard classification. We hypothesized that a retrospective analysis of applications of the Key Characteristics approach to cancer hazard classification using heterogenous mechanistic data on diverse agents would be informative for systematic reviews in decision-making. We extracted information on the conclusions, data types, and the role mechanistic data played in the cancer hazard classification from each Monograph. Statistical analyses identified patterns in the use of Key Characteristics, as well as trends and correlations among Key Characteristics, data types, and ultimate decisions. Despite gaps in data for many agents and Key Characteristics, several significant results emerged. Mechanistic data from in vivo animal, in vitro animal, and in vitro human studies were most impactful in concluding that an agent could cause cancer via a Key Characteristic. To exclude the involvement of a Key Characteristic, data from large-scale systematic in vitro testing programs such as ToxCast, were most informative. Overall, increased availability of systemized data streams, such as human in vitro data, would provide the basis for more confident and informed conclusions about both positive and negative associations and inform expert judgments on cancer hazard.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    本文提供了使用Comet测定法对hormetic剂量反应发生的首次评估,基因毒性试验.使用基于Hormetic数据库的先验评估标准,对同行评审的彗星测定实验结果进行评估,获得了许多剂量反应的例子。这些反应发生在大范围和不同范围的细胞类型和来自广泛范围的化学类别的试剂中。在使用先验输入和评估标准进行的彗星测定实验研究中,尝试进行了有限的尝试,结果表明频率在40%范围内。这些发现很重要,因为它们表明广泛的遗传毒性化学物质显示出强烈提示剂量反应的证据。这些发现对研究设计问题有重要意义,包括选择的剂量数量,剂量范围和间距。同样,在这种基因毒性试验中,剂量反应的广泛发生具有重要的风险评估意义.
    The paper provides the first assessment of the occurrence of hormetic dose responses using the Comet assay, a genotoxic assay. Using a priori evaluative criteria based on the Hormetic Database on peer-reviewed comet assay experimental findings, numerous examples of hormetic dose responses were obtained. These responses occurred in a large and diverse range of cell types and for agents from a broad range of chemical classes. Limited attempts were made to estimate the frequency of hormesis within comet assay experimental studies using a priori entry and evaluative criteria, with results suggesting a frequency in the 40% range. These findings are important as they show that a wide range of genotoxic chemicals display evidence that is strongly suggestive of hormetic dose responses. These findings have significant implications for study design issues, including the number of doses selected, dose range and spacing. Likewise, the widespread occurrence of hormetic dose responses in this genotoxic assay has important risk assessment implications.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    这项研究的目的是评估在面向患者的数字风险分层工具分类过程中添加临床筛选器的实用性,以识别有资格进行遗传性癌症遗传风险评估的患者。对数字风险分层条目进行回顾性审查,以确定符合遗传风险评估条件的患者总数。还对这些进行了分析,以确定临床筛查人员重新联系了多少患者,以及在临床筛查人员修订了他们的个人和家族史后,有多少重新联系的患者符合标准。数字风险分层分诊工具完成率为89.9%,22.6%需要与临床筛查人员联系。在完成数字工具的640名患者中,在临床筛查人员修订了他们的个人和/或家族史后,5.9%的人符合测试标准。总的来说,51.1%的患者符合遗传风险评估标准。临床筛选器的添加进一步增加了对有资格进行遗传风险评估的患者的识别。在与临床筛查人员联系后,约有一半符合标准的患者仅根据他们对癌症的个人诊断就符合标准。将临床筛选器结合到数字筛选过程可以用于减少患者完成工具的障碍并提高癌症遗传服务的患者识别率。
    The purpose of this study was to evaluate the utility of adding a clinical screener to the patient-facing digital risk stratification tool triage process for the identification of patients eligible for a genetic risk assessment for hereditary cancer. Digital risk stratification entries were retrospectively reviewed to determine the overall number of patients eligible for genetic risk assessment. These were also analyzed to determine how many patients were re-contacted by the clinical screener, and how many of those recontacted patients met criteria after their personal and family history was revised by the clinical screener. There was an 89.9% digital risk stratification triage tool completion rate, with 22.6% requiring contact from the clinical screener. Of the 640 patients who completed the digital tool, 5.9% met criteria for testing after their personal and/or family history was revised by the clinical screener. Overall, 51.1% of patients met criteria for a genetic risk assessment. The addition of a clinical screener further increased identification of patients eligible for genetic risk assessment. About half of patients who met criteria after being contacted by the clinical screener met criteria based on their personal diagnosis of cancer alone. Incorporation of a clinical screener to the digital screening process may serve to reduce barriers to patient completion of the tool and increase rates of patient identification for cancer genetic services.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号