Preferences for Genetic Testing to Predict the Risk of Developing Hereditary Cancer: A Systematic Review of Discrete
N Morrish1, T Snowsill2, S Dodman3
1Public Health Economics Group, Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
Summary
Understanding patient preferences for genetic testing in hereditary cancer syndromes is crucial. People prioritize test effectiveness and detection rates, and are willing to pay for improvements, especially when results are shared with doctors.
Area of Science:
- Health Economics
- Genetics
- Public Health
Background:
- Understanding service user preferences is vital for effective healthcare decision-making and resource allocation.
- This is particularly important for high-risk patients where predictive genetic testing can significantly alter health outcomes.
Approach:
- A systematic review was conducted using discrete choice experiment (DCE) terms combined with hereditary cancer syndromes and genetic testing keywords.
- Searches covered multiple databases including Medline, Embase, PsycINFO, HMIC, Web of Science, and EconLit.
- Seven studies met the inclusion criteria, focusing on DCEs investigating patient or public preferences for predictive genetic testing in hereditary cancer syndromes.
Key Points:
- Test effectiveness and detection rates were consistently the most important attributes for respondents.
- Accuracy, cost, and wait time were also important, with cost reduction potentially improving uptake.
- Willingness to pay was highest for improved detection rates, multi-cancer identification, and results shared with clinicians over insurers.
Conclusions:
- Policy makers should prioritize test effectiveness and detection rates in genetic testing for hereditary cancer syndromes.
- Reducing the cost of genetic testing could enhance its adoption.
- Future research should explore the influence of sociodemographic factors and health system policies on these preferences.
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