Public Interest in Population Genetic Screening for Cancer Risk

Megan C Roberts; Kimberly S Foss; Gail E Henderson; Sabrina N Powell; Katherine W Saylor; Karen E Weck; Laura V Milko

doi:10.3389/fgene.2022.886640

Public Interest in Population Genetic Screening for Cancer Risk

Front Genet. 2022 Jul 22:13:886640. doi: 10.3389/fgene.2022.886640. eCollection 2022.

Authors

Megan C Roberts¹, Kimberly S Foss², Gail E Henderson³, Sabrina N Powell², Katherine W Saylor⁴, Karen E Weck^{2

5}, Laura V Milko²

Affiliations

¹ Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, NC, United States.
² Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
³ Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
⁴ Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
⁵ Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.

Abstract

An emerging role for DNA sequencing is to identify people at risk for an inherited cancer syndrome in order to prevent or ameliorate the manifestation of symptoms. Two cancer syndromes, Hereditary Breast and Ovarian Cancer and Lynch Syndrome meet the "Tier 1" evidence threshold established by the Centers for Disease Control and Prevention (CDC) for routine testing of patients with a personal or family history of cancer. Advancements in genomic medicine have accelerated public health pilot programs for these highly medically actionable conditions. In this brief report, we provide descriptive statistics from a survey of 746 US respondents from a Qualtrics panel about the public's awareness of genetic testing, interest in learning about their cancer risk, and likelihood of participating in a population genetic screening (PGS) test. Approximately of half the respondents were aware of genetic testing for inherited cancer risk (n = 377/745, 50.6%) and would choose to learn about their cancer risk (n-309/635, 48.7%). Characteristics of those interested in learning about their cancer risk differed by educational attainment, age, income, insurance status, having a primary care doctor, being aware of genetic testing, and likelihood of sharing information with family (p < 0.05). A sizeable majority of the respondents who were interested in about learning their cancer risk also said that they were likely to participate in a PGS test that involved a clinical appointment and blood draw, but no out-of-pocket cost (n = 255/309, 82.5%). Reasons for not wanting to participate included not finding test results interesting or important, concerns about costs, and feeling afraid to know the results. Overall, our results suggest that engaging and educating the general population about the benefits of learning about an inherited cancer predisposition may be an important strategy to address recruitment barriers to PGS.

Keywords: DNA sequencing; barriers; cancer; population genetic screening; public awareness.