Background:Pancreatic cancer (PC) remains one of the deadliest malignancies, with long-term survival often reliant on early detection through surgery and chemotherapy. Unfortunately, the late-stage presentation of the disease contributes to its poor prognosis, leading to an increased focus on surveillance for high-risk individuals (HRIs) to facilitate earlier diagnosis. Despite the growing implementation of such programmes globally, there is a lack of longitudinal studies examining the benefits of PC surveillance, particularly regarding the well-being of participants. The study aimed to evaluate the distress experienced by HRIs 3-years after engaging in PC screening at Verona Pancreas Institute and to describe which participant characteristics contributed to the increase in stress.Methods:This is a longitudinal follow-up (FU) of a previously published cohort. HRIs with heredo-familial predisposition undergoing PC surveillance with MRCP and a clinical visit were re-evaluated from 2019 to 2023 in the same psychological assessment using Perceived Stress Scale (PSS), General Self-Efficacy Scale (GSES), Coping Orientation to Problems Experienced (COPE) and The Scale of Perceived Social Support (MSPSS) 3 years after the baseline assessment. The FU assessments were conducted by a clinical psychologist via telephone after the radiological and clinical evaluations were made.Results:Of the 54 HRIs initially evaluated, ten did not respond to phone contacts. The remaining 44 HRIs, of whom 29 (65.9%) were female, with a mean age of 56.1 years (SD = 10.2), agreed to participate in a FU psychological assessment. After 3 years, the participant exhibited an increase in stress levels (PSS—T0 mean 14.8; T1 mean 16.9), a decrease in problem-solving abilities (GSES—from 32.02 to 28.09,p< 0.01), a deterioration in adaptive capacity to the situation (COPE total score from 64.0 to 61.39,p= 0.05), and a reduction in perceived social support (MSPSS—T0: 4.59; T1: 4.27,p= 0.02). A significant decrease was also observed in the use of denial (from 2.84 to 2.32;p= 0.02). Based on the psychological characteristics of the 44 HRIs, stratified according to PSS reassessed at FU, 3 distinct clusters were identified: (a) Normal Stress (32% of the sample): HRIs with a PSS score < 14; (b) Stable Clinical Stress (46% of the sample): HRIs with PSS at FU > 14 and PSS at baseline > 14; (c) New Clinical Stress (22% of the sample): HRIs with PSS at FU > 14 and PSS at baseline < 14. After 3 years of surveillance for PC, 67% of the total study sample (Stable Clinical Stress group and New Clinical Stress group) exhibited high perceived stress. Over the course of the 3 years, 7 HRIs (15.9%) lost a family member due to PC.Conclusions:The data suggest the need to include psychological care pathways within the surveillance programmes. These insights can enhance existing literature and aid in creating comprehensive surveillance programmes for PC, addressing all care aspects, including mental health.
背景：胰腺癌（PC）仍是最致命的恶性肿瘤之一，长期生存往往依赖于通过手术和化疗实现早期发现。遗憾的是，该疾病通常在晚期才被发现，导致预后不良，这使得对高风险个体（HRIs）进行监测以促进早期诊断的关注日益增加。尽管此类项目在全球范围内逐渐实施，但缺乏纵向研究来检验胰腺癌监测的益处，特别是在参与者的福祉方面。本研究旨在评估在维罗纳胰腺研究所参与胰腺癌筛查3年后HRIs所经历的痛苦，并描述哪些参与者特征导致了压力的增加。 方法：这是对先前发表队列的纵向随访（FU）。对具有遗传家族易感性的HRIs进行胰腺癌监测，包括磁共振胰胆管成像（MRCP）和临床访视，在基线评估3年后（2019年至2023年）使用感知压力量表（PSS）、一般自我效能量表（GSES）、应对问题经历取向量表（COPE）和感知社会支持量表（MSPSS）进行相同的心理评估。随访评估由临床心理学家在完成放射学和临床评估后通过电话进行。 结果：在最初评估的54名HRIs中，有10名未接听电话。其余44名HRIs同意参与随访心理评估，其中29名（65.9%）为女性，平均年龄为56.1岁（标准差=10.2）。3年后，参与者表现出压力水平增加（PSS—T0均值14.8；T1均值16.9）、解决问题能力下降（GSES—从32.02降至28.09，p<0.01）、对情境的适应能力恶化（COPE总分从64.0降至61.39，p=0.05）以及感知社会支持减少（MSPSS—T0：4.59；T1：4.27，p=0.02）。否认策略的使用也显著减少（从2.84降至2.32；p=0.02）。根据44名HRIs的心理特征，按随访时重新评估的PSS分层，确定了3个不同的集群：（a）正常压力组（占样本的32%）：PSS评分<14的HRIs；（b）稳定临床压力组（占样本的46%）：随访时PSS>14且基线时PSS>14的HRIs；（c）新发临床压力组（占样本的22%）：随访时PSS>14且基线时PSS<14的HRIs。经过3年的胰腺癌监测，总研究样本的67%（稳定临床压力组和新发临床压力组）表现出高感知压力。在3年期间，有7名HRIs（15.9%）因胰腺癌失去了家庭成员。 结论：数据表明需要在监测项目中纳入心理护理路径。这些见解可以丰富现有文献，并有助于创建全面的胰腺癌监测项目，解决包括心理健康在内的所有护理方面。
肿瘤(癌症)患者之家