Factors influencing discussion of cancer genetic testing with healthcare providers in a 2018 population based survey

Authors: Makhnoon S, Yu R, Cunningham SA, Peterson SK, Shete S

Category: Early Detection & Risk Prediction
Conference Year: 2020

Abstract Body:
Background: Discussion of clinical genetic testing options with healthcare care providers has typically been the first step towards receiving testing to inform cancer risk assessment, prevention and early detection. Healthcare providers are a trusted source of medical information for most patients and play a critical role in ensuring access to clinical genetic testing for eligible individuals. Given the rapid evolution in genetic testing practice in oncology, up- to-date data representing the population-level landscape of cancer genetic testing behavior is needed. Methods: A questionnaire including items regarding cancer information seeking was administered online to a non-probability Texas population sample. Weighted multivariable logistic regression analysis identified key factors associated with discussion of genetic testing with a provider. Results: Respondents (n=2029; mean age 44.4 years) were 45.5% non-Hispanic white, 35.6% Hispanic and 10% Black. Most (91.9%) had no personal history of cancer, however 62.6% had family history of cancer. Overall, 11% of our sample discussed cancer genetic testing with healthcare providers. This discussion was associated with younger age, having a personal history of breast, ovarian or colon cancer (OR=11.7), and family history of any cancer (OR=1.64). Respondents who sought any health information from any source were less likely to discuss genetic testing with a provider (OR=0.6) compared to those who did not seek health information. Discussion was positively associated with the belief that inherited genetic predisposition significantly affects cancer development (OR=1.7) compared to the belief that other behavioral factors contribute to cancer. Belief in the possibility of cancer prevention was positively associated with discussion (OR=1.65) compared to the belief that cancer prevention was not possible. Conclusion: The 11% cancer genetic testing discussion rate is considerably higher than previously reported estimates and may be attributed to increased public awareness of direct-to-consumer genetic testing, as well as increasing adoption of evidence- based recommendations for genetic testing among healthcare providers. Those who may benefit from genetic testing were more likely to discuss testing with a provider.

Keywords: genetic testing, cancer, healthcare provider, population