Sibel Saya1, Jennifer G McIntosh2, Ingrid M Winship3, Shakira Milton4, Mark Clendenning5, Mary Kyriakides6, Jasmeen Oberoi7, Daniel D Buchanan8, Mark A Jenkins9, Jon D Emery10. 1. Centre for Cancer Research, University of Melbourne, Melbourne, Australia; Department of General Practice, University of Melbourne, Melbourne, Australia. Electronic address: sibel.saya@unimelb.edu.au. 2. Centre for Cancer Research, University of Melbourne, Melbourne, Australia; Department of General Practice, University of Melbourne, Melbourne, Australia; Department of Software Systems & Cybersecurity, Monash University, Melbourne, Australia. Electronic address: jenny.mcintosh@monash.edu. 3. Department of Medicine, The University of Melbourne, Melbourne, Australia; Genomic Medicine & Family Cancer Clinic, Royal Melbourne Hospital, Melbourne, Australia. Electronic address: Ingrid.Winship@mh.org.au. 4. Centre for Cancer Research, University of Melbourne, Melbourne, Australia; Department of General Practice, University of Melbourne, Melbourne, Australia. Electronic address: shakira.milton@unimelb.edu.au. 5. Centre for Cancer Research, University of Melbourne, Melbourne, Australia; Colorectal Oncogenomics Group, Department of Clinical Pathology, University of Melbourne, Melbourne, Australia. Electronic address: mark.clendenning@unimelb.edu.au. 6. Centre for Cancer Research, University of Melbourne, Melbourne, Australia; Department of General Practice, University of Melbourne, Melbourne, Australia. Electronic address: mky@unimelb.edu.au. 7. Centre for Cancer Research, University of Melbourne, Melbourne, Australia; Department of General Practice, University of Melbourne, Melbourne, Australia. Electronic address: jasmeen.oberoi@unimelb.edu.au. 8. Centre for Cancer Research, University of Melbourne, Melbourne, Australia; Colorectal Oncogenomics Group, Department of Clinical Pathology, University of Melbourne, Melbourne, Australia; Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Australia. Electronic address: daniel.buchanan@unimelb.edu.au. 9. Centre for Cancer Research, University of Melbourne, Melbourne, Australia; Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Australia. Electronic address: m.jenkins@unimelb.edu.au. 10. Centre for Cancer Research, University of Melbourne, Melbourne, Australia; Department of General Practice, University of Melbourne, Melbourne, Australia; The Primary Care Unit, University of Cambridge, Cambridge, UK. Electronic address: jon.emery@unimelb.edu.au.
Abstract
OBJECTIVE: A genomic test to predict personal risk of colorectal cancer (CRC) that targets screening and could be feasibly implemented in primary care. We explored informed decision-making and attitudes towards genomic testing in this setting. METHODS: A CRC genomic test was offered to 150 general practice patients with brief discussion of its implications. We measured informed choice about the test, consisting knowledge, attitudes and test uptake. Sixteen purposively-sampled participants were interviewed. RESULTS: Of 150, 142 (95%) completed the informed choice measure and of 27 invited, 16 (59%) completed an interview. 73% made an informed choice about the test. Interviews revealed that participants with inadequate knowledge on the informed choice scale still understood the gist of the test. While positive attitudes were most prevalent, some had concerns, and many were indifferent to the test. Positive attitudes included: that risk information could facilitate risk reduction; negative attitudes included: that risk results could cause worry and be used for insurance discrimination; indifferent attitudes included: that the test seemed benign and it was easy to do. CONCLUSIONS: Our study adds to the evidence that genomic tests for CRC risk do not pose significant concern to patients in community settings. PRACTICE IMPLICATIONS: As genomic tests become more prevalent, this study's findings can be used to facilitate informed decision-making and ensure equitable access.
OBJECTIVE: A genomic test to predict personal risk of colorectal cancer (CRC) that targets screening and could be feasibly implemented in primary care. We explored informed decision-making and attitudes towards genomic testing in this setting. METHODS: A CRC genomic test was offered to 150 general practice patients with brief discussion of its implications. We measured informed choice about the test, consisting knowledge, attitudes and test uptake. Sixteen purposively-sampled participants were interviewed. RESULTS: Of 150, 142 (95%) completed the informed choice measure and of 27 invited, 16 (59%) completed an interview. 73% made an informed choice about the test. Interviews revealed that participants with inadequate knowledge on the informed choice scale still understood the gist of the test. While positive attitudes were most prevalent, some had concerns, and many were indifferent to the test. Positive attitudes included: that risk information could facilitate risk reduction; negative attitudes included: that risk results could cause worry and be used for insurance discrimination; indifferent attitudes included: that the test seemed benign and it was easy to do. CONCLUSIONS: Our study adds to the evidence that genomic tests for CRC risk do not pose significant concern to patients in community settings. PRACTICE IMPLICATIONS: As genomic tests become more prevalent, this study's findings can be used to facilitate informed decision-making and ensure equitable access.
Authors: Sibel Saya; Lucy Boyd; Patty Chondros; Mairead McNamara; Michelle King; Shakira Milton; Richard De Abreu Lourenco; Malcolm Clark; George Fishman; Julie Marker; Cheri Ostroff; Richard Allman; Fiona M Walter; Daniel Buchanan; Ingrid Winship; Jennifer McIntosh; Finlay Macrae; Mark Jenkins; Jon Emery Journal: Trials Date: 2022-09-27 Impact factor: 2.728