Online genetic testing for lung cancer susceptibility: Predictors of uptake and informed decision making in smokers related to patients with lung cancer

A4 Once available, demand for genetic susceptibility testing for common diseases could quickly outstrip services offered by providers to discuss the risks, benefits, and implications of this testing. Therefore, there may be reason to consider alternate, minimal-interaction paradigms and delivery models, such as the Internet, to address some of this demand, as well as to aid integration into evidence-based behavior change interventions. To this end, we examined rates and predictors of accessing a web-based program offering genetic susceptibility testing for lung cancer [GSTM1] to smokers who were blood relatives of patients with late stage lung cancer. Baseline eligibility was assessed via a telephone survey. Participants could log on to a website to consider genetic susceptibility testing; those who did were offered the GSTM1 test. Decision-making quality was assessed via testing-related knowledge and the concordance between test-related attitudes and test uptake. Dependent variables were whether the smoker logged on to the website and the quality of the test-taking decision (informed vs. less informed). 530 relative-smokers who were identified by patients were sent letters describing the baseline telephone survey. Of these, 212 actively or passively refused the baseline survey or we were unable to contact them by phone. A total of 304 (57.4%) completed the baseline survey; 180 were ineligible. 116 of the 124 relatives who met eligibility criteria expressed interest in learning about genetic testing via a web-based program. 58 (50%) logged on to the study website. Those who logged on expressed greater quit motivation, were more aware of cancer genetic testing, and were more frequent Internet users than those who did not log on. 44 (38%) were tested. Twenty-four participants made an “informed” decision to be tested; 32 made informed decisions not to be tested. The remaining sample (52%) made less informed decisions. Post-hoc tests revealed that among participants whose knowledge and attitudes suggested that they would be interested in taking the genetic test, those who did not log on reported a significantly closer relationship to their lung cancer-affected relative compared to those who did log on ( F = 5.97, p F = 4.62, p F = 5.67, p