“Don't Want No Risk and Don't Want No Problems”: Public Understandings of the Risks and Benefits of Noninvasive Prenatal Testing in the United States

Abstract

Background: The recent availability of new noninvasive prenatal genetic tests for fetal aneuploidy has raised questions concerning whether and how these new tests will be integrated into prenatal medical care. Among the many factors to be considered are public understandings and preferences about prenatal testing mechanisms and the prospect of fetal aneuploidy. Methods: To address these issues, we conducted a nationwide mixed-method survey of 2,960 adults in the United States to explore justifications for choices among prenatal testing mechanisms. Open responses were qualitatively coded and grouped by theme. Results: Respondents cited accuracy, followed by cost, as the most significant aspects of prenatal testing. Acceptance of testing was predicated on differing valuations of knowledge and on personal and religious beliefs. Trust in the medical establishment, attitudes toward risk, and beliefs about health and illness were also considered relevant. Conclusions: Although a significant portion of the sample population valued the additional accuracy provided by the new noninvasive tests, they nevertheless expressed concerns over high costs. Furthermore, participants continued to express reservations about the value of prenatal genetic information per se, regardless of how it was obtained.