Genetic and environmental risk assessment for colorectal cancer risk in primary care practice settings.

A33

Abstract Background. The assessment of genetic variants and environmental exposures (i.e., genetic and environmental risk assessment or GERA) may permit individualized risk stratification for common diseases as part of routine care. A developmental study was conducted to assess the uptake of and response to testing for colorectal cancer (CRC) risk among asymptomatic patients in primary care practice settings. Methods . Physicians in primary care practices identified patients eligible for CRC screening and referred them to the study. Research staff administered a baseline survey to consenting patients. At a scheduled office visit, participants underwent decision counseling with a trained nurse educator to facilitate informed decision making about being tested for Methylene TetraHydroFolate Reductase (MTHFR) status and red blood cell folate level. Test results were disclosed within two weeks after the visit. A post-visit and one-month endpoint survey were administered. Univariable analyses of survey data were performed to assess changes from baseline in GERA and CRC screening-related knowledge and perceptions. Results . Fifty-seven patients were referred to the study. Twenty-five (44%) patients consented to the study, and all but one were tested. Participant knowledge about GERA and CRC screening, perceived CRC screening response efficacy, and perceived social support for CRC screening increased significantly from baseline. Participants reported low levels of intrusive thoughts about CRC. Conclusions. Test acceptance was almost universal among study participants. Knowledge and favorable perceptions of CRC screening increased after exposure to decision counseling and testing. Further research is needed to assess GERA uptake and impact at the population level.