Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2018 Dec;37(12):1134-1144.
doi: 10.1037/hea0000683. Epub 2018 Oct 11.

Behavioral impact of return of genetic test results for complex disease: Systematic review and meta-analysis

Maia J Frieser  1 , Sylia Wilson  2 , Scott Vrieze  2
Affiliations
Meta-Analysis

Behavioral impact of return of genetic test results for complex disease: Systematic review and meta-analysis

Maia J Frieser et al. Health Psychol. 2018 Dec.

Abstract

Objective: Advances in genomewide association studies have made possible the return of genetic risk results for complex diseases. Two concerns about these results are (a) negative psychological consequences and (b) viewing probabilistic results as deterministic, leading to misinterpretation and inappropriate decisions. The present study evaluates these concerns through a meta-analytic review of existing literature.

Method: Seventeen genetic testing studies of complex disease, including 1,171 participants and reporting 195 effects, 104 of which were unadjusted for covariates, were meta-analyzed under a random effects model. Diseases included Alzheimer's, cardiovascular and coronary heart disease, lung cancer, melanoma, thrombophilia, and type II diabetes. Six domains of behavioral-psychological reactions were examined.

Results: Carriers showed significantly increased self-reported behavior change compared to noncarriers when assessed 6 months or later after results return (Hedges's g = .36, p = .019).

Conclusions: Return of genetic testing results for complex disease does not strongly impact self-reported negative behavior or psychological function of at-risk individuals. Return of results does appear to moderately increase self-reported healthy behavior in carriers, although research on objectively observed behavior change is needed. This is a growing area of research, with preliminary results suggesting potential positive implications of genetic testing for complex disease on behavior change. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. PRISMA flowchart of literature review.
Figure 2.
Figure 2.. Forest Plot of Only Unadjusted Meta-Analytic Results.
Forest plot of only unadjusted meta-analytic effect sizes for each of the six psychological and behavioral outcomes at the three timepoints; Baseline, ≤6 months, > 6 months, including which studies the effects were calculated from, carrier and non-carrier total N, number of effects included in the overall effect, and a 95% confidence interval and p value. Study number key: 1: Aspinwall, 2008, 2: Aspinwall, 2009, 3: Aspinwall, 2013, 4: Aspinwall, 2014, 5: Chao, 2008, 6: Christensen, 2016, 7: Grant, 2013, 8: Green, 2009, 9: Heshka, 2008, 10: Hietaranta-Luoma, 2014, 11: Hietaranta-Luoma, 2015, 12: Kasparian, 2009, 13: Kullo, 2016, 14: Legnani, 2006, 15: Sanderson, 2008, 16: Sanderson, 2009, 17: Vernarelli, 2010.
See this image and copyright information in PMC

References

    1. Accreditation Council for Genetic Counseling. (2016). Accredited Programs. Retrieved from http://gceducation.org/Pages/Accredited-Programs.aspx
    1. Aspinwall LG, Leaf SL, Dola ER, Kohlmann W, & Leachman SA (2008). CDKN2A/p16 genetic test reporting improves early detection intentions and practices in high-risk melanoma families. Cancer Epidemiology Biomarkers & Prevention, 17(6), 1510–1519. doi:10.1158/1055-9965.epi-08-0010 - DOI - PubMed
    1. Aspinwall LG, Leaf SL, Kohlmann W, Dola ER, & Leachman SA (2009). Patterns of photoprotection following CDKN2A/p16 genetic test reporting and counseling. J Am Acad Dermatol, 60(5), 745–757. doi:10.1016/j.jaad.2008.12.034 - DOI - PubMed
    1. Aspinwall LG, Taber JM, Kohlmann W, Leaf SL, & Leachman SA (2014). Unaffected family members report improvements in daily routine sun protection 2 years following melanoma genetic testing. Genetics in Medicine, 16(11), 846–853. doi:10.1038/gim.2014.37 - DOI - PMC - PubMed
    1. Aspinwall LG, Taber JM, Leaf SL, Kohlmann W, & Leachman SA (2013). Melanoma Genetic Counseling and Test Reporting Improve Screening Adherence Among Unaffected Carriers 2 Years Later. Cancer Epidemiology Biomarkers & Prevention, 22(10), 1687–1697. doi:10.1158/1055-9965.epi-13-0422 - DOI - PMC - PubMed