Interest in genetic testing and risk-reducing behavioral changes: results from a community health assessment in New York City

Abstract

Risk-based genetic tests are often used to determine cancer risk, when to initiate screening, and frequency of screening, but rely on interest in genetic testing. We examined overall interest in genetic testing for cancer risk assessment and willingness to change behavior, and whether these are affected by demographic or socioeconomic factors.We conducted a community needs health survey in 2019 among primary care and cancer patients, family members and community members in New York City. We used univariable analysis and relative risk regression to examine interest in genetic cancer risk testing and willingness to modify lifestyle behaviors in response to an informative genetic test.Of the 1225 participants, 74.0% (n = 906) expressed interest in having a genetic test to assess cancer risk. Interest in genetic testing was high across all demographic and socioeconomic groups; reported interest in genetic testing by group ranged from 65.0 (participants aged 65 years and older) to 83.6% (participants below federal poverty level). Among the 906 participants that reported interest in genetic testing, 79.6% were willing to change eating habits, 66.5% to change exercise habits, and 49.5% to lose weight in response to an informative genetic test result.Our study reveals that interest in genetic testing for cancer risk is high among patients and community members and is high across demographic and socioeconomic groups, as is the reported willingness to change behavior. Based on these results, we recommend that population-based genetic testing may result in greater reduction cancer risk, particularly among minoritized groups.

Keywords: Cancer risk; Community health; Genetic testing; Lifestyle.

Fig. 1

Percent of participants who reported interest in genetic testing for cancer risk, overall and by stratification group. The blue line shows the unstratified percent for reference. Among all participants, 74% reported interest in genetic testing for cancer risk. Interest in genetic testing remained high (< 50%) by sociodemographic group. *Statistically significant

Fig. 2

Percent reported willingness to make behavioral changes in light of an informative genetic test result by stratification group. (a) Percent reported willingness to make changes to diet, (b) percent reported willingness to make changes to exercise, (c) percent reported willingness to lose weight. The blue line shows the unstratified percent reported to make behavioral change. * Statistically significant

Fig. 3

Risk ratio forest plot by stratification group for each behavioral change. Risk ratios and 95% CIs by sociodemographic factor for willingness to (a) make changes to diet, (b) make changes to exercise, and (c) lose weight. Line depicts RR = 1.0; reference group for each stratification is a single point without confidence intervals