Psychosocial factors associated with the public's willingness to pay for genetic testing for cancer risk: a structural equations model

An adaptation of Andersen's behavioral model of health services utilization is used to examine the psychosocial and socio-demographic factors that dir ectly and indirectly influence the likelihood of undergoing genetic suscept ibility testing for cancer, and the amount of money that individuals would be willing to pay out-of-pocket for such a test. Apart from willingness and likelihood, the model also included perceived benefits and barriers, perce ived susceptibility, dispositional optimism, information seeking, family hi story of cancer, socioeconomic status (SES), and age, and explained 30.3% o f the variation in willingness. We found as hypothesized that likelihood of undergoing such tests was central to understanding willingness to pay. Bei ng aware of genetic susceptibility testing for cancer, and talking and seek ing information about it was directly associated with an increased chance o f being willing to pay more, independent of other indirect associations (ef fects), Interventions targeting those with a family history of cancer and t hose with a higher SES should generate more awareness about the potential p ositive and negative consequences to one's family of testing, and the inter face between family history of cancer and perceived susceptibility. Interve ntions should also motivate people to talk and seek more information about genetic testing for cancer risk to enable them take well-informed decisions .