Genetic testing for colon cancer among African-Americans in North Carolina

Objective. To describe attitudes and correlates of intention to take a genetic test for colon cancer in a population-based sample of African-Americans. Methods. African-Americans (n = 658), age 18–70, in North Carolina completed an 11-page questionnaire between June–October 2003 that assessed attitudes (familiarity, perceived benefits and risks, anxiety, and confidentiality) and intention to take a genetic test for colon cancer and various participant characteristics. Results. Respondents expressed favorable attitudes and high intention regarding genetic testing for colon cancer: 87% would definitely/probably take a genetic test, although only 42% had read/heard a lot or some about genetic testing. Most agreed that genetic test results should be available to healthcare providers (79%) but not to health insurers (62%) or employers (82%). About a third were concerned that genetic testing could lead to discrimination. Correlates of intention differed by sex. Perceived benefits were significantly positively associated with intention among all respondents. However, being married (OR = 2.1, 95% CI: 1.2, 3.7), doctor as the main source of health information (OR = 2.4, 95% CI: 1.4, 3.9), and colon cancer family history (OR = 4.3, 95% CI: 1.6, 11.6) were significant only for women; some college education (OR = 4.1, 95% CI: 1.7, 9.7), importance of sharing test results with relatives (OR = 5.5, 95% CI: 1.6, 18.7), and colon cancer screening history (OR = 3.4, 95% CI: 1.6, 7.5) were only significant for men. Conclusions. Respondents expressed high interest in genetic testing for colon cancer risk, although confidentiality of test results is a concern. Guidelines and policies for genetic testing specific to African-Americans should be established and future research should examine the prevalence of genetic testing.