Patient-Physician Communication Among Women With Lynch Syndrome
Posted: Thursday, August 29, 2019
For women with Lynch syndrome, the hereditary cancer syndrome associated with a predisposition to colorectal, endometrial, and ovarian cancers, current National Comprehensive Cancer Network (NCCN) Guidelines suggest that gynecologic risk-reducing surgery be considered to lower or eliminate the chance of endometrial or ovarian cancer. However, for women who decline surgery, regular screening with endometrial biopsy every 1 to 2 years is recommended. In a study published in Hereditary Cancer in Clinical Practice, researchers found that a positive patient-physician relationship appears to be related to improved health self-efficacy to manage Lynch syndrome, as well as a higher perceived effectiveness of gynecologic screening.
“Those who felt more confident that their family physician understands the risks associated with Lynch syndrome reported higher self-efficacy to seek and obtain information about Lynch syndrome,” stated Tae L. Hart, PhD, of Ryerson University in Toronto, and colleagues.
In this study, 50 women with Lynch syndrome who had not undergone risk-reducing surgery completed a questionnaire regarding demographics, sources of information about Lynch syndrome utilized, gynecologic screening behaviors, health self-efficacy, patient-physician relationships, and beliefs about physician management of Lynch syndrome. The investigators found that transvaginal ultrasound was the most common screening behavior (57%), followed by pelvic ultrasound (47%). Just 22% of respondents underwent endometrial biopsy, the screening tool recommended in the NCCN Guidelines. Patients most commonly received general and screening-specific information about Lynch syndrome from genetic counselors.
Significant correlations were identified between better patient-physician relationships and greater health self-efficacy; however, this finding was not associated with increased engagement in gynecologic cancer screening. Higher rates of information exchange between patient and physician and greater patient involvement in care also correlated with a patient’s perceived effectiveness of the CA-125 blood test, pelvic ultrasound, and transvaginal ultrasound.
Disclosure: The study authors reported no conflicts of interest.