Abstract B35: Factors associated with beliefs about genetics related to cancer risk among racial and ethnic adults 18 years and older in the United States

Background: Recent data suggest a widening gap in the utilization of genetic testing for determining cancer risk among certain racial and ethnic groups in the United States (U.S.). As the availability increases, it remains unclear why minority populations are less likely to engage in genetic testing as compared to non-Hispanic Whites (NHW). It has been postulated that a host of factors may contribute to the disproportionate uptake of genetic testing; however, it remains unclear which factors are most salient for minority populations. The objective of this study was to examine the factors associated with beliefs about genetic testing among a racially and ethnically diverse group of adults in the U.S. Understanding these factors will further our understanding regarding the disparity in the uptake of genetic testing.

Methods: Data for this study were obtained from the National Cancer Institute's 2014 Health Information National Trends Survey (HINTS) Cycle 4, a cross-sectional survey of 2,753 American adults by telephone and postal mail. Bivariate chi-square analyses were conducted to examine the association between each explanatory variable (gender, race/ethnicity, age, level of education, level of income, genetic test knowledge) and the belief that health behaviors (i.e., diet, exercise, and smoking) determine whether a person will develop cancer and the belief that genetics determine whether a person will develop cancer. Multivariable logistic regression analyses were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) to determine whether race, genetic testing knowledge, health behavior beliefs, and sociodemographic factors affect beliefs in cancer genetics risk. Analyses were conducted using SAS version 9.4.

Results: After adjusting for socioeconomic status, factors associated with higher odds of reporting that genetics determine whether a person will develop cancer was gender. Women were more than twice as likely to believe that genetics determine whether a person will develop cancer (AOR= 2.20; 95% CI=1.46,3.34). The factors associated with lower odds of reporting that genetics determine whether a person will develop cancer were: African American (AA) (AOR=0.52; 95% CI=0.30,0.89); Hispanic (AOR=0.57;95% CI=0.32,0.99); non-Hispanic Asian (AOR=0.33; 95% CI=0.14,0.79); Other, including Alaska Natives, American Indians, Native Hawaiians, or other Pacific Islanders, and non-Hispanic multiple race (AOR=0.38; 95% CI=0.15,0.95); those with a high school or less than high school education (AOR=0.34; 95% CI=0.19,0.60 and AOR=0.48; 95% CI=0.23-0.99, respectively); those who were age 75 and older (AOR=0.40; 95% CI=0.18,0.88); those earning less than $20,000 income (AOR=0.23; 95% CI=0.09,0.60); and those who believe that health behaviors determine whether a person will develop cancer (AOR=0.08; 95% CI=0.05,0.13). Contrary to our expectations, knowledge of genetic testing was found to be not statistically significant (AOR=0.81; 95% CI=0.50,1.31; p-value=0.39).

Conclusion: This study found that individuals not self-identified as non-Hispanic White, individuals over the age of 74, those who did not attain any college education, and individuals who earned less than $20,000 per year were less likely to have the belief that genetic testing can determine whether a person will develop cancer. Future studies are needed to further understand these factors among minority groups in the context of genetic testing. The findings of these studies should inform the development of culturally- , literacy- , and age-appropriate educational materials and targeted community-based cancer risk-communication programs aimed at minority populations to reduce the barriers to genetic testing.

Citation Format: Lawrence P. McKinney, Gemechu Gerbi, Mechelle Claridy, Brian Rivers. Factors associated with beliefs about genetics related to cancer risk among racial and ethnic adults 18 years and older in the United States [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B35.