Attitudes toward colon cancer gene testing: Survey of relatives of colon cancer patients

Objectives. Various studies have identified psychosocial factors that may i nfluence attitudes toward colon cancer gene testing. Whereas family history of colon cancer has been associated with interest in gene testing, this ha s not been examined extensively. We hypothesized that the strength of famil y history of colon cancer is associated with risk perception and willingnes s to undergo gene testing. Materials and Methods. We evaluated attitudes toward colon cancer gene test ing among persons who had at least one first-degree relative with colon can cer. A total of 2680 at-risk relatives in 863 kindreds were identified and mailed an extensive survey regarding sociodemographic variables, family his tory, health behaviors and knowledge, and willingness to take a colon cance r gene test. A total of 55.6% of persons completed and returned surveys. We conducted a brief telephone survey of a random sample of 200 persons who d id not respond to the mail survey. Results. The combined study sample of 1373 people was 42% male, had a mean age of 55 +/- 15 years, was 96% white, and had moderate-to-high SES. A tota l of 77.4% were very likely to take the gene test, and 92.4% were somewhat or very likely to take the gene test. A total of 78% of the sample perceive d a higher colon cancer risk, although patterns of risk perception and worr y differed significantly between mail survey and telephone survey responden ts. More of the telephone survey respondents were also somewhat unlikely or very unlikely to take the gene test compared to the mail survey respondent s (13.7% versus 6.9%). In the combined sample, concern about developing col on cancer and risk perception increased with number of relatives with colon cancer (P < 0.0001), Eight percent expressed no concern about developing c olon cancer; 4.8% felt their chance of developing colon cancer was lower th an others of the same age, sex, and race; and 3.3% felt that they were very unlikely to develop colon cancer in their lifetime. However, there was str ong interest in gene testing regardless of the number of affected relatives , and persons with more affected relatives were generally willing to pay mo re for the gene test (up to $1000). Conclusions. The strength of family history of colon cancer is associated w ith risk perception but not with willingness to undergo gene testing.