Abstract
There is currently great interest in using genetic risk estimates for common disease in personalized healthcare. Here we assess melanoma risk-related preventive behavioral change in the context of the Coriell Personalized Medicine Collaborative (CPMC). As part of on-going reporting activities within the project, participants received a personalized risk assessment including information related to their own self-reported family history of melanoma and a genetic risk variant showing a moderate effect size (1.7, 3.0 respectively for heterozygous and homozygous individuals). Participants who opted to view their report were sent an optional outcome survey assessing risk perception and behavioral change in the months that followed. Participants that report family history risk, genetic risk, or both risk factors for melanoma were significantly more likely to increase skin cancer preventive behaviors when compared to participants with neither risk factor (ORs = 2.04, 2.79, 4.06 and p-values = 0.02, 2.86 × 10−5, 4.67 × 10−5, respectively), and we found the relationship between risk information and behavior to be partially mediated by anxiety. Genomic risk assessments appear to encourage positive behavioral change in a manner that is complementary to family history risk information and therefore may represent a useful addition to standard of care for melanoma prevention.
Highlights
Personalized medicine promises customized individual healthcare that goes beyond the genetic screening already commonplace in obstetrics, oncology, and pharmacology [1]
As part of the ongoing CPMC, which is a prospective research study focused on the impact that disease risk assessment has on health outcomes [12,13], participants are given personalized melanoma risk reports that include genetic and family history risk factors for melanoma and subsequently
We found that any increased risk for melanoma is significantly associated with increased preventive behaviors, and this association is partially mediated by anxiety
Summary
Personalized medicine promises customized individual healthcare that goes beyond the genetic screening already commonplace in obstetrics, oncology, and pharmacology [1]. It remains unclear how probabilistic rather than diagnostic or functional genetic information can contribute to improving health outcomes [2], or if such information produces adverse psychological effects such as anxiety and/or wasteful over-utilization of healthcare services [3]. In the case of melanoma, a form of skin cancer that affects melanocytes, behavioral modifications such as skin self-examination, the use of sunscreen and protective clothing, and avoidance of UV light exposure represent relatively simple and accessible ways to reduce the overall risk of developing the disease [5]. By self-report, only one-third of the US population regularly applies sunscreen; 41% regularly wear fully sun-protective clothing; and only
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