Perceptions and Use of Germline Genetic Testing Among Patients With Prostate Cancer

Many patients with prostate cancer are eligible for germline genetic testing, but it is underutilized in clinical practice. We aimed to explore perceptions of and decision making about undergoing genetic testing among patients with prostate cancer.

This qualitative interview study enrolled patients diagnosed with prostate cancer who had been treated at a safety-net hospital and had received a referral for genetic testing in the previous 12 months. Participants completed an interview in their native language via telephone. Data on genetic testing use were captured in interviews and via the medical record. A thematic analysis explored factors related to decision making in concert with genetic testing use.

Thirty-three English-speaking (n = 25), Spanish-speaking (n = 6), and Haitian Creole-speaking (n = 2) patients completed interviews. In interviews, 19 reported completing genetic testing, 10 reported no testing, and four were unsure. Medical records indicated 24 had undergone genetic testing-including six participants whose self-reported testing status was no or unsure. Four main themes identified factors that influenced participant-reported genetic testing decisions: gendered perceptions of value to family, personal utility of genetic results, preferences for information, and relative priority of testing. Many participants did not view testing as a priority and delayed or declined testing because of cancer treatment burden.

These results suggest opportunities to improve communication about testing purpose, value, and utility in those affected by cancer. Conversations about the utility of both the individual benefit of obtaining genetic testing for those affected by prostate cancer and implications for familial cascade testing are warranted.