Factors Influencing Discussion of Cancer Genetic Testing with Health-Care Providers in a Population-Based Survey

Abstract

<b><i>Introduction:</i></b> Discussion of cancer genetic testing with health-care providers (HCPs) is necessary to undergo testing to inform cancer risk assessment and prevention. Given the rapid evolution in genetic testing practice in oncology, we describe the current landscape of population-level cancer genetic testing behaviors. <b><i>Methods:</i></b> A questionnaire including items regarding discussion of cancer genetic testing with HCPs was administered to a nonprobability sample (<i>N</i> = 2,029) of the Texas population. <b><i>Results:</i></b> Overall, 11% of respondents discussed cancer genetic testing with HCPs. In multivariable analysis, discussion was significantly related to having a personal history of breast/ovarian/colon cancer (OR = 11.57, 95% CI = 5.34–25.03), personal history of other cancer (OR = 3.18, 95% CI = 1.69–5.97), and health information-seeking behaviors (OR = 1.73, 95% CI = 1.12–2.66). Surprisingly, respondents who believed that inherited predispositions in addition to other modifiable risk factors cause cancer were less likely to discuss genetic testing compared to those who did not believe that inherited cancer predispositions cause cancer (OR = 0.54, 95% CI = 0.36–0.79). <b><i>Discussion:</i></b> The high discussion rate may be attributed to increased public awareness of genetic testing and adoption of more inclusive clinical genetic testing guidelines. The findings suggest that efforts to increase public awareness of the utility of genetic testing on personalized cancer risk assessment and cancer prevention are needed.

Are beliefs about the importance of genetics for cancer prevention and early detection associated with high risk cancer genetic testing in the U.S. Population?

“…The seeming disconnect between attitude and behavior in cancer genetic testing and cancer prevention beliefs aligns with results from a prior population survey from our group. Specifically, respondents who believed that inherited predispositions cause cancer were less likely to discuss genetic testing with a healthcare provider compared to those who did not believe that inherited cancer predispositions cause cancer ( Makhnoon et al, 2021 ). This may indicate an interaction between fatalism and limited knowledge of the potential preventive benefits of genetic testing, however additional research to better understand the general public’s beliefs about the role of genetics in cancer prevention is warranted.…”