Confusion abounds over genetic testing

A lthough genetic tests for colon and breast cancer suscepti- bility genes are only designed for people with a strong family history of the cancers, many people, regardless of their potential genetic risk, say they're interested in getting tested, researchers find. Meanwhile, some populations, such as African-American women, may decline testing even if they have a good reason to get tested.

Misinformation about genetic testing is likely fueling both the over- enthusiastic interest and disinterest, says Deborah Bowen, PhD, one of three guest editors of a special issue of the journal Cancer Epidemiology, Biomarkers and Prevention on genetic testing. And that's something primary-care physicians will need to think about as they gain access to genetic tests for breast and colon cancer. Meanwhile, many researchers wonder if physicians are prepared to handle the tests' psychological implications and the many people who may request testing for psychological rather than medical reasons (see article on page 16).

In a study Bowen published in the special issue she co-edited, she and her colleagues found that more than 70 percent of a general sample of women were interested in genetic testing for breast cancer, despite the fact that for most of them a negative result would say nothing about their vulnerability to the disease.

"Many women, regardless of their medical risk, erroneously judge themselves as being candidates for genetic testing," says Bowen, of the Fred Hutchinson Cancer Research Center in Seattle.

In contrast, Heiddis Valdimarsdottir, PhD, of Mount Sinai School of Medicine, is finding it difficult to get a group of African-American women to even come in and talk about genetic testing for breast cancer. While more than 90 percent of Caucasian women offered genetic counseling agreed to come in, fewer than 40 percent of African-American women have agreed, even though many of them have family histories of breast cancer.

Such findings point to the need to educate women about genetic testing and breast-cancer risk, as well as deal with their emotions surrounding breast cancer, say researchers. Now that any primary-care physician can perform genetic tests for breast and colon cancer, they will need to begin dealing with many of these issues. And they may not be prepared, say researchers.

"The preliminary data show that many primary-care providers don't have sufficient knowledge about the implications of genetic test results or of the efficacy of risk reduction and screening," adds Georgetown University psychologist Caryn Lerman, PhD, who studies genetic testing. "That makes it hard for them to provide truly informed consent. Also, most physicians are not prepared for those patients who are vulnerable to psychological distress."

APA Home Page . Search . Site Map