Informed choice and attitudes regarding a genomic test to predict risk of colorectal cancer in general practice

Abstract

ObjectiveA genomic test to predict personal risk of colorectal cancer (CRC) that targets screening and could be feasibly implemented in primary care. We explored informed decision-making and attitudes towards genomic testing in this setting. MethodsA CRC genomic test was offered to 150 general practice patients with brief discussion of its implications. We measured informed choice about the test, consisting knowledge, attitudes and test uptake. Sixteen purposively-sampled participants were interviewed. ResultsOf 150, 142 (95%) completed the informed choice measure and of 27 invited, 16 (59%) completed an interview. 73% made an informed choice about the test. Interviews revealed that participants with inadequate knowledge on the informed choice scale still understood the gist of the test. While positive attitudes were most prevalent, some had concerns, and many were indifferent to the test. Positive attitudes included: that risk information could facilitate risk reduction; negative attitudes included: that risk results could cause worry and be used for insurance discrimination; indifferent attitudes included: that the test seemed benign and it was easy to do. ConclusionsOur study adds to the evidence that genomic tests for CRC risk do not pose significant concern to patients in community settings. Practice implicationsAs genomic tests become more prevalent, this study’s findings can be used to facilitate informed decision-making and ensure equitable access.