Predictors of Genetic Testing for Hereditary Cancer in Qualified Individuals

Background and Methods: We surveyed individuals in the United States whose personal and/or family history met clinical criteria for genetic testing for cancer susceptibility. Using univariate and multivariable logistic regression analyses, we examined demographic and clinical factors associated with self-reported receipt of clinical genetic testing. Results Of the 1,269 respondents with personal and/or family history meeting clinical criteria for genetic testing, 48.1% reported having undergone clinical genetic testing. Testing uptake varied by cancer type (p<0.05) and was highest among individuals with personal diagnoses of breast (73.9%), ovarian (88.2%), and pancreatic (70.2%) cancers, as compared with prostate cancer (33.6%). Females were significantly more likely than males to have undergone genetic testing (odds ratio, OR, 1.67, CI: 1.17-2.37), and people 70 years or older were less likely to have had testing when compared with those age under 50 (OR 0.33, CI: 0.22-0.48). Individuals who were diagnosed with cancer 15 or more years ago were less likely to have had genetic testing than those with more recent cancer diagnoses (OR 0.47 CI: 0.30-0.74). Individuals who were eligible to receive genetic testing based on their family history of cancer alone were less likely to have had testing than those with a personal cancer diagnosis (OR 0.65, CI: 0.44-0.97). Conclusion While clinical genetic testing is routinely offered to specific groups of patients at risk for hereditary cancer syndromes (especially those with a personal or family history of breast and/or ovarian cancers), uptake remains low among men and among individuals who qualify for genetic testing based on diagnoses of non-gynecologic cancers and/or family history alone. Patient- and clinician-facing interventions are needed to raise awareness of indications for clinical genetic testing for cancer susceptibility.