A discrete choice experiment (DCE) study evaluating preferences of Asian adults for inherited cancer risk testing.

Abstract

e13550 Background: Inherited cancer genetic testing (CGT) is increasingly recommended in a wide range of settings to better evaluate and manage personal and/or family cancer risks. For individuals at risk, identification of monogenic risk factors by inherited CGT allows more appropriate advice, surveillance and targeted prevention. For cancer patients, inherited CGT provides guidance for the selection of targeted therapy treatment options. Little is known about the views of non-Western global communities, which can impact cancer prevention. We designed a DCE study to evaluate four key attributes to better target educational and policy interventions in an urban Asian community. Methods: We recruited healthy adults in the community aged between 21-60 in Singapore. Participants received basic information about cancer and cancer genetic testing, then completed a 16-task DCE survey that examined preferences for four attributes of cancer genetic testing for targeted prevention including: accuracy, waiting time for result, out-of-pocket cost and insurance claims. A conditional logit regression model was used to examine the main effect parameter, assuming all attributes have an independent influence on the participants’ preferences. Results: 93 adults were enrolled (71% female, 29% male). Attributes influencing decision to undergo inherited CGT in decreasing order of concern were accuracy (37%), out-of-pocket costs (22%), insurance claim (21%) and waiting time for result (20%). Increased out-of-pocket cost reduces the likelihood of people to go for testing (coef: -6.579e−04, p < 0.01). The impact of financial cost is less important for participants with increased monthly household income (coef: 1.791e−04, p < 0.01). Conclusions: With inherited cancer genetic testing becoming more common and relevant in terms of personal and/or family risk managements and guiding treatment options, this DCE study is helpful to guide clinicians tailor of individualized genetic counseling for non-Western communities, who may have different concerns from Western populations. Targeted policy intervention and education on these concerns may lead to greater accessibility for inherited CGT.