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?
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?
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DOI：
10.1016/j.pmedr.2022.101781
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发表时间：
2022-06
影响因子：
2.8
通讯作者：
Shete S
中科院分区：
文献类型：
--
作者：
Makhnoon S;Maki KG;Yu R;Peterson SK;Shete S
公众对遗传癌症的生殖系基因检测普遍持积极态度。过去的研究表明，不同的因果信念和背景因素与基因检测的吸收有关。然而，目前尚不清楚关于基因信息癌症预防和早期检测的信念最终如何影响检测行为。我们使用来自国家健康信息国家趋势调查（提示5周期4）的数据来评估这些信念以及与癌症遗传学相关的信念与参与癌症基因检测之间的关系。总体而言，5.24%的总加权样本接受了癌症基因检测，其中70.5% （n = 141）没有个人癌症病史，而其他人则有乳腺癌、卵巢癌或结直肠癌（23.0%）或其他癌症（6.5%）的个人诊断。在调整后的多变量分析中，检测与乳腺癌、卵巢癌或结直肠癌的个人病史（or = 28.37, 95% CI: 10.19-79.04）、女性（or = 2.97, 95% CI: 1.41-6.26）、对癌症的高度担忧（or = 4.78, 95%: 2.19-10.45）呈正相关，与西班牙裔（or = 0.37, 95%: 0.16-0.86）或非西班牙裔亚裔（or = 0.12, 95% CI: 0.04-0.33）呈负相关。相信遗传学对癌症早期检测的重要性与检测相关（OR = 18.03, 95% CI: 4.07-79.79），而相信遗传学对癌症预防的重要性与检测无关。检测和相信基因对癌症早期检测的重要性之间的联系，而不是癌症预防，是一个令人惊讶的发现，值得进一步研究。更好地了解这些信念及其对测试吸收的潜在影响可能会为群体基因检测工作提供信息。
Public attitudes towards germline genetic testing for inherited cancers have been found to be generally positive. Past research demonstrated that diverse causal beliefs and contextual factors are associated with uptake of genetic testing. However, it is unclear how beliefs about genetically informed cancer prevention and early detection ultimately shape testing behaviors. We used data from the National Health Information National Trends Survey (HINTS 5 Cycle 4) to evaluate these beliefs and the relationship between beliefs related to cancer genetics and participation in cancer genetic testing. Overall, 5.24% of the total weighted sample underwent cancer genetic testing, of whom 70.5% (n = 141) had no personal history of cancer, whereas others had a personal diagnosis of breast, ovarian, or colorectal cancer (23.0%), or other cancers (6.5%). In adjusted multivariable analysis, testing was positively associated with personal history of breast, ovarian, or colorectal cancer (OR = 28.37, 95% CI: 10.19–79.04), female sex (OR = 2.97, 95% CI: 1.41–6.26), having high cancer worry (OR = 4.78, 95%: 2.19–10.45), and negatively associated with being Hispanic (OR = 0.37, 95%: 0.16–0.86) or non-Hispanic Asian (OR = 0.12, 95% CI: 0.04–0.33). Belief in the importance of genetics for early detection of cancer was associated with testing (OR = 18.03, 95% CI: 4.07–79.79), whereas belief in the importance of genetics for cancer prevention was not. The association between testing and belief about the importance of genetics for early detection of cancer, but not cancer prevention, is a surprising finding that warrants further research. Better understanding of these beliefs and their potential impact on test uptake may inform population genetic testing efforts.
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