Parental Communication With their Children about Cancer Risk and DTC Cascade Genetic Testing: Implications for...

Area of Science:

• Genetics and Genomics
• Oncology
• Public Health

Background:

• Cascade genetic testing for inherited cancer syndromes can improve family health outcomes through early detection and risk management.
• Clinical guidelines generally advise against predictive genetic testing in minors, including direct-to-consumer (DTC) genetic testing.
• Understanding parental preparation for pediatric cascade genetic testing is crucial for informed decision-making and family health.

Purpose of the Study:

• To examine how parents with hereditary cancer predispositions prepare their children, particularly adolescents and young adults, for cascade genetic testing.
• To identify factors influencing parental decisions to discuss hereditary cancer risk and genetic testing with their children.
• To explore parental perceptions of the risks and benefits associated with direct-to-consumer (DTC) genetic testing for pediatric cascade testing.

Main Methods:

• Survey administered to 126 parents with pathogenic variants for adult-onset inherited cancers identified through DTC testing panels.
• Data collected on children's awareness of parental cancer predisposition and discussions about genetic testing participation.
• Statistical analysis to identify predictors of parental disclosure of hereditary cancer risk and discussion of cascade testing.

Main Results:

• 81% of children were aware of their parents' hereditary cancer predisposition.
• 62% of parents had discussed their children's potential participation in cancer genetic testing.
• Parents of older children, those with higher confidence in using genetic information, and those with more favorable views on pediatric genetic testing were more likely to discuss testing with their children.

Conclusions:

• A majority of high-risk parents engage in discussions about hereditary cancer and genetic testing options with their older children.
• Parental factors, including child's age and parental confidence/opinions regarding genetic information, significantly influence cascade testing discussions.
• Further research is needed to clarify the role of healthcare professionals in guiding families through cascade genetic testing decisions, including DTC testing implications.