Exposure to risk information and women's interest in direct to consumer testing for BRCA 1 and 2 mutations

Abstract

6526 Background: Direct to consumer (DTC) access to cancer genetic testing has the potential to enhance cancer control efforts. However, it is not known if current DTC websites provide adequate risk information for informed medical decision-making. Methods: 767 women were randomly assigned to view a “mock” DTC commercial website (control condition: CC, n=257) or the same “mock” website that included information on the potential risks of obtaining genetic testing online (risk condition: RC). Risk information was framed in two different ways: basic risk information (BR, n=253) and risk information from expert sources (ES, n=257). Subjects then completed an online survey. The primary endpoints were intentions to get BRCA testing and attitudes about DTC BRCA testing. Results: Sample characteristics: mean age 37 (range 18–71), 79% white, 62% married, mean education 3 yrs. college. Women in the RC reported lower intentions to get BRCA testing than women in the CC (mean 2.78 vs. 3.07, p<0.05) and were more likely to report wanting to obtain testing in clinic rather than online (mean 5.11 vs. 4.83, p<0.05). Women in the RC had more negative attitudes about online BRCA testing than women in the CC (mean 23.76 vs. 25.18, p <0.001). Framing effects were seen: women in the ES group were more likely to report a preference for clinic based testing and had more negative attitudes about online testing than the BR group. Conclusions: Exposing women to information on the potential risks of online BRCA testing altered their intentions to get testing as well as their attitudes about testing. Additionally, some risk messages appear to be more effective in altering attitudes and intentions than other risk messages. Policy makers may want to consider both the content and framing of risk information on DTC commercial websites as they enact regulation aimed at optimizing informed decision-making in this rapidly growing industry. No significant financial relationships to disclose.