Patient decisions regarding cancer gene panel testing: An exploratory study

Area of Science:

• Oncology
• Genetics
• Medical Sociology

Background:

• Multi-gene panel testing is increasingly used in cancer genetic counseling.
• Patient decision-making regarding specific panel selection is not fully understood.
• Understanding patient preferences is crucial for optimizing genetic counseling services.

Purpose of the Study:

• To investigate factors influencing patient choice of multi-gene panel tests in a cancer genetic counseling setting.
• To identify associations between patient demographics, concerns, and genetic testing decisions.
• To explore patient preferences for different types of gene panels.

Main Methods:

• Survey of 228 patients and their genetic counselors at a cancer genetic counseling clinic.
• Assessment of demographic and clinical characteristics, patient concerns, and session outcomes.
• Analysis of factors associated with the selection of specific multi-gene panel tests.

Main Results:

• 85.1% of patients pursued genetic testing, with 56.2% selecting large pan-cancer panels.
• White patients were more likely than non-white patients to undergo testing.
• Test choice was associated with the number of options offered, education, age, and NCCN Guidelines status, as well as concerns about screening and family dynamics.
• Patient income, cancer diagnosis, and family structure were not predictive of test choice.

Conclusions:

• Patients show a strong preference for large gene panels, but test selection is complex and difficult to predict.
• Results highlight existing disparities in cancer genetic testing access and uptake.
• Further research is needed to fully understand patient decision-making processes for multi-gene panel tests.