Acceptance and attitudes towards genetic cancer testing among German general practice patients: a cross-sectional survey.
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OBJECTIVE: This study describes acceptance and attitudes towards genetic cancer testing among German primary care patients. DESIGN: Cross-sectional survey. SETTING: Primary care. PARTICIPANT: Systematically recruited patients aged ≥18 years from six general practices in Mecklenburg-Western Pomerania participated in an anonymous self-administered survey on familial cancer prevention (n=479 and 67.0% participation rate). Those with complete data were analysed (n=424; mean age 53.7, SD 16.6 years; men 34.4%). Linear regression analyses were used to examine potential disparities in general acceptance of genetic testing and attitudes towards genetic cancer testing according to sociodemographics and familial cancer knowledge. RESULT: General acceptance of genetic testing was high, particularly among younger, higher-educated individuals and those with a family history of cancer and higher familial cancer knowledge. For example, 83.3% either agreed or strongly agreed that it should be available to anybody. The most important benefits of genetic cancer testing were to guide check-up frequency (81.4%), to inform medical decision-making (80.2%) and to understand children's risk (75.2%). The most important concerns included the potential burden on the family (44.6%) and the belief that cancer cannot be prevented (39.2%). More favourable attitudes were found among younger, higher-educated individuals, those with a personal history of cancer and those with fewer children or no partner. For example, higher age was linked to lower benefit (regression coefficient (RC) -0.01, 95% CI -0.01 to -0.001) and higher concern ratings (RC 0.01, 95% CI 0.002 to 0.01). About a third (34.7%) rated not wanting to know about genetic alterations that increase their cancer risk as a (very) important reason against testing. Information avoidance was higher among older individuals (RC 0.02, 95% CI 0.01 to 0.02), women (RC 0.40, 95% CI 0.11 to 0.69), those with lower education (RC -0.64, 95% CI -0.91 to -0.36) and those with more children (RC 0.21, 95% CI 0.09 to 0.33). CONCLUSION: Acceptance of genetic testing was high, but barriers remain, particularly among older adults, women, the less educated and those with more children. Targeted educational efforts to improve health literacy, emphasise the preventive potential of genetic testing and emotional support through genetic counselling are essential to overcome these barriers and promote informed decision-making.