Abstract PR-07: Skin cancer concerns and genetic risk information seeking in primary care

Abstract

Abstract Skin cancers are among the most rapidly increasing cancers in the United States. The most serious form, melanoma, is relatively common in younger adults and has a high mortality rate if it becomes metastatic. Growing evidence from genome-wide association studies is identifying genetic variants associated with skin cancer risk. Accordingly, it is being suggested that genomic testing for these variants could enable personalized feedback of susceptibility to skin cancer as an innovative approach to motivate adoption of preventive behaviors. Little is known about the receptivity of healthy adults to genetic risk information for common diseases such as cancer. We investigated whether cognitive factors (worry and perceived skin cancer risk), family factors (family health history awareness, family or personal cancer history, family constellation and social influences on health), behavioral factors (sunburn and sunscreen use history), and level of general health information-seeking relate to perceived importance of learning about how genes affect personal health risks. These research questions were examined using baseline assessment data from the Multiplex Initiative, a primary-care based study examining interest and uptake of genetic susceptibility testing for eight common diseases in a large Midwestern health maintenance organization. The sample included 1959 members, ages 25–40, who had not been diagnosed with any of the eight conditions on the genetic test. About 53% of participants were female; 37% were white and 53% black. Most (75%) had at least some college education. Average level of perceived importance of learning about genes was high (X=5.55; 1–7 scale). To highlight interactions between covariates, we used recursive partitioning classification and regression trees (RPART) to identify predictors of perceived importance of learning about genes among white and black respondents. In whites, the tree correctly classified 79% of the participants, such that those participants who perceived that others close to them wanted them to learn more about keeping healthy, were highly worried about skin cancer, and reported lower perceived skin cancer risk were most likely to endorse high levels of perceived importance of learning about genes; other variables did not substantially improve model accuracy. Findings were similar for blacks. This study indicates that the perceived investment of family and friends regarding health-focused information seeking may be a primary motivator for learning about how genes affect health, and that investigation of actual and perceived social support and social influences may improve our understanding of how cognitive and information seeking processes relate to interest and uptake of genetic information in primary care settings. Citation Information: Cancer Prev Res 2010;3(1 Suppl):PR-07.