Predictors of Cancer Genetic Testing Among U.S. Adults: Insights From the Health Information National Trends Survey 7

Progress in molecular genomics has increased the accessibility, availability, and affordability of genetic testing to correctly identify individuals at elevated risk for hereditary cancers. Understanding the sociodemographic, clinical, and behavioural factors influencing genetic testing uptake is essential to addressing disparities and guiding targeted interventions.

This study aimed to assess the prevalence of cancer genetic testing in U.S. adults, while correlating it with various predictors of clinical and behavioural aspects, using data from the 2024 Health Information National Trends Survey 7 (HINTS 7).

We analysed data from the HINTS 7, a nationally representative, cross-sectional survey conducted in 2024. The analytic cohort included 514 adult respondents, corresponding to an estimated 20.7 million U.S. adults. Survey-weighted bivariate analyses were used to examine patterns of genetic testing. Additionally, multivariable logistic regression estimated adjusted odds ratios (aORs) for associations between predictors and the likelihood of undergoing cancer genetic testing using Stata 19 (StataCorp LLC, College Station, TX).

Overall, 23.4% of U.S. adults reported having undergone genetic testing. Compared to respondents aged 18-34, those aged 35-49 (aOR = 4.69, 95% CI: 1.90-11.56) and 50-64 (aOR = 6.60, 95% CI: 2.67-16.33) were significantly more likely to have been tested. Non-Hispanic Black adults (aOR = 5.55, 95% CI: 2.31-13.35) and individuals of "Other" racial/ethnic backgrounds (aOR = 4.37, 95% CI: 1.46-13.06) also had higher odds compared to non-Hispanic Whites. Participants with annual household incomes between $20,000 and $34,999 (aOR = 3.80, 95% CI: 1.43-10.11) and those with a personal history of cancer (aOR = 4.32, 95% CI: 1.86-9.99) were more likely to have undergone testing. Notably, higher trust in healthcare providers was inversely associated with testing (aOR = 0.18, 95% CI: 0.04-0.87), whereas use of health/wellness apps increased the odds (aOR = 2.12, 95% CI: 1.05-4.26).

Age, race/ethnicity, income, personal cancer history, trust in healthcare providers, and engagement with digital health tools were significant predictors of cancer genetic testing. These findings underscore the need for targeted outreach and education, particularly among younger adults, certain racial/ethnic groups, and individuals with lower engagement in digital health, to ensure equitable access to genetic testing.