Women's Intention to Participate in Predictive Breast Cancer Genetic Testing: A Cross-Sectional Survey of in Iran

Breast cancer is the most prevalent cancer among women worldwide, with rising trends in prevalence, incidence, and mortality rates. Genetic testing for BRCA1 and BRCA2 variants plays a pivotal role in assessing risk and enabling early detection. Despite its importance, participation in breast cancer screening programs, including genetic testing, remains notably low in Iran. This study aimed to assess Iranian women's intention to undergo predictive genetic testing for breast cancer and identify associated factors to inform policymakers and intervention strategies.

A cross-sectional online survey was conducted from July to August 2021 among 1041 Iranian women aged 30 and above. A validated questionnaire assessed demographics, psychological factors, personal and family cancer history, knowledge of breast cancer genetics, attitudes toward genetic testing, and testing intentions. Statistical analyses included Chi-square tests, Fisher's Exact Test, and logistic regression to identify predictors of testing intention.

Most participants (89.5%) expressed willingness to undergo genetic testing if it were free. Higher knowledge of breast cancer genetics (OR = 1.59, p = 0.038) and positive attitudes toward testing (OR = 1.59, p = 0.042) were significant predictors of intention. Married women and those with a history of breast cancer screening were more likely to have undergone testing (p = 0.03 and p = 0.02, respectively). However, a family history of cancer and perceived risk showed no significant association with testing intentions.

Despite limited knowledge, Iranian women demonstrated a strong interest in genetic testing for breast cancer. Educational interventions and policy measures to reduce financial barriers could enhance participation rates. Tailored programs addressing psychological concerns and improving genetic literacy are recommended to support informed decision-making and early detection efforts.