Journal of Clinical Oncology (abstract)
Significant
concerns exist regarding the potential for unwarranted behavior changes
and the overuse of health care resources in response to
direct-to-consumer personal genomic testing (PGT).
However, little is
known about customers’ behaviors after PGT.
Longitudinal
surveys were given to new customers of
23andMe (Mountain View, CA) and
Pathway Genomics (San Diego, CA). Survey data were linked to
individual-level PGT results through a secure data transfer process.
Of
the 1,042 customers who completed baseline and 6-month surveys
(response rate, 71.2%),
762 had complete cancer-related data and were
analyzed. Most customers reported that learning about their genetic risk
of cancers was a motivation for testing (colorectal, 88%; prostate,
95%; breast, 94%).
No customers tested positive for pathogenic mutations
in highly penetrant cancer susceptibility genes. A minority of
individuals received elevated single nucleotide polymorphism-based PGT
cancer risk estimates (colorectal, 24%; prostate, 24%; breast, 12%). At 6
months, customers who received elevated PGT cancer risk estimates were
not significantly more likely to change their diet, exercise, or
advanced planning behaviors or engage in cancer screening, compared with
individuals at average or reduced risk. Men who received elevated PGT
prostate cancer risk estimates changed their vitamin and supplement use
more than those at average or reduced risk (22%
v 7.6%,
respectively; adjusted odds ratio, 3.41; 95% CI, 1.44 to 8.18).
Predictors of 6-month behavior include baseline behavior (exercise,
vitamin or supplement use, and screening), worse health status (diet and
vitamin or supplement use), and older age (advanced planning,
screening).
Most
adults receiving elevated direct-to-consumer PGT single nucleotide
polymorphism-based cancer risk estimates did not significantly change
their diet, exercise, advanced care planning, or cancer screening
behaviors.
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