Patients at risk for hereditary cancer syndromes sometimes decline clinically appropriate genetic testing. The purpose of the current study was to understand what preferences, concerns, and desires informed their refusal as well as their current level of interest in being tested. We interviewed patients who had been seen in a hereditary cancer clinic at Vanderbilt University Medical Center and had declined genetic testing. In all, 21 in-depth, semi-structured qualitative interviews were conducted. Although patients provided many reasons for declining testing, they most often cited their psychosocial state at the time of the initial invitation to participate in genetic testing as their reason for refusal. The majority (67%) said that they either would or had changed their mind about testing if/when their clinicians 'mentioned it again'. Patients at risk for hereditary cancer who refuse testing at the time of genetic counseling may later change their mind. In particular, if a patient declines testing around the time of a major medical diagnosis or intervention, clinicians who are providing ongoing care may want to raise the topic afresh after the patient has had time to recover from initial distress related to diagnosis or treatment. Strategies to prompt clinicians to have these conversations are suggested.

中文翻译：

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患者在最初拒绝后重新考虑癌症基因检测的意愿：再次提及。

有遗传性癌症综合征风险的患者有时会拒绝临床上合适的基因检测。当前研究的目的是了解哪些偏好、顾虑和愿望导致他们拒绝接受测试，以及他们目前对接受测试的兴趣程度。我们采访了在范德比尔特大学医学中心的遗传性癌症诊所就诊并拒绝基因检测的患者。总共进行了 21 次深入、半结构化的定性访谈。尽管患者提供了许多拒绝检测的原因，但他们最常将最初邀请参加基因检测时的心理社会状态作为拒绝的原因。大多数人 (67%) 表示，如果/当他们的临床医生“再次提及”时，他们要么会或已经改变了测试的想法。在遗传咨询时拒绝检测的有遗传性癌症风险的患者可能会在以后改变主意。特别是，如果患者在重大医疗诊断或干预期间拒绝检测，提供持续护理的临床医生可能希望在患者有时间从与诊断或治疗相关的最初痛苦中恢复过来后重新提出这个话题。建议采取策略来促使临床医生进行这些对话。在患者有时间从与诊断或治疗相关的最初痛苦中恢复过来后，提供持续护理的临床医生可能希望重新提出这个话题。建议采取策略来促使临床医生进行这些对话。在患者有时间从与诊断或治疗相关的最初痛苦中恢复过来后，提供持续护理的临床医生可能希望重新提出这个话题。建议采取策略来促使临床医生进行这些对话。