PERSONALIZED PREVENTIVE MEDICINE AND ITS CONSEQUENCES: THE IMPACT OF PREDICTIVE GENOMIC TESTING ON RISK PERCEPTION AND WORRY

Purpose: The purpose of this study was to assess the impact of receiving results from a commercially available predictive genomic testing product on patients’ perceptions of risk and worry for 12 conditions including several cancers as well as cardiovascular, metabolic, and autoimmune diseases.

Method: Patients of 12 preventive medicine physicians who had appointments scheduled during a pre-determined 2-week block of time were randomized to receive either genomic risk information from a direct-to-consumer genomic testing product in addition to usual care (n = 74), or usual care alone (n = 76). Following their medical appointments, all patients completed a survey containing two items in which they were asked to rate their perception of risk and level of worry for each of the 12 conditions included in the predictive genomic testing panel. We used Pearson chi-square tests to assess differences in levels of risk and worry in the two groups (two-tailed α = 0.05).

Result: Of 352 patient participants approached, 150 (43%) agreed to participate, 64 refused (18%), and 131 (37%) did not respond after two invitation phone calls. Predictive genomic testing significantly increased risk perception in 4 conditions (abdominal aneurysm [p = 0.001], Graves’ disease [p = 0.04], obesity [p = 0.01], and osteoarthritis [p = 0.04]) and significantly decreased perceptions of risk in 1 condition (prostate cancer [p = 0.02]). For all but 3 conditions, patients who received predictive genomic risk information had higher overall ratings of risk perception than those in the control group. Receiving predictive genomic testing results had a moderate impact on levels of worry, with intervention group participants reporting non-significantly higher levels of worry for 7 conditions and lower but still non-significant levels for 5 conditions compared to controls.

Conclusion: Receiving predictive genomic information does impact perceptions of risk and levels of worry, but does so to different degrees and in different directions depending upon the condition being tested. Whether such testing increases accurate risk perception of objective disease risk remains unclear. Future studies could examine whether the seemingly modest and mixed direction of impact that predictive genomic testing exerts on risk perception and worry actually influences health behaviors.