Abstract

Background: In precision medicine, somatic and germline DNA sequencing are essential to make genome-guided treatment decisions in cancer patients. However, it can also uncover unsolicited findings (UFs) in germline DNA that could have a substantial impact on the lives of patients and their relatives. It is therefore critical to understand cancer patients' preferences concerning UFs derived from whole-exome (WES) or whole-genome sequencing (WGS). Methods: In a quantitative multi-center study, adult cancer patients (any stage and origin of disease) were surveyed through a digital questionnaire based on previous semi-structured interviews. Background knowledge was provided by showing two videos, introducing basic concepts of genetics and general information about different categories of UFs (actionable, non-actionable, reproductive significance, unknown significance). Findings: In total 1072 patients were included of whom 701 participants completed the whole questionnaire. Overall, 686 (85.1%) participants wanted to be informed about UFs in general. After introduction of four UFs categories, 113 participants (14.8%) changed their answer: 718 (94.2%) participants opted for actionable variants, 537 (72.4%) for non-actionable variants, 635 (87.0%) participants for UFs of reproductive significance and 521 (71.8%) for UFs of unknown significance. Men were more interested in receiving certain UFs than women: non-actionable: OR 3.32; 95% CI 2.05 - 5.37, reproductive significance: OR 1.97; 95% CI 1.05 - 3.67 and unknown significance: OR 2.00; 95% CI 1.25 - 3.21. In total 244 (33%) participants conceded family members to have access to their UFs while still alive. 603 (82%) participants agreed to information being shared with relatives, after they would pass away. Interpretation: Our study showed that the vast majority of cancer patients desires to receive all UFs of genome testing, although a substantial minority does not wish to receive non-actionable findings. Incorporation of categories in informed consent procedures supports patients in making informed decisions on UFs. Funding Statement: This work was supported by the Dutch Cancer Foundation (KWF) [grant UU2014-7469]. Declaration of Interests: The authors have declared no conflicts of interest. Ethics Approval Statement: The research protocol was approved by the Research Ethics Committee of the University Medical Center Utrecht (The Netherlands), and informed consent was obtained from all participants

Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call