PRECISION MEDICINE

General Population Has Interest in Genetic Testing for Skin Cancer Risk

There is moderately high interest and follow through among the general population for genetic testing to determine melanoma skin cancer risk, according to a study published in JAMA Dermatology. However, there are difference in uptake based on socioeconomic and demographic factors, with less uptake among less educated individuals and minorities, including.

The melanocortin-1 receptor gene (MC1R) is known to be associated with melanoma risk, even after adjusting for other factors like hair color and skin type.

There is hope that knowledge of genetic risk may promote skin cancer awareness foster increased prevention-related behaviors (e.g., using sunscreen). Yet, to date, the direct-to-consumer testing model has primarily only reached white, highly educated consumers. Melanoma risk is known to be high among Hispanics, particularly in states with high levels of year-round sun exposure.

The present study assessed prevalence of interest in and uptake of MC1R testing among internal medicine clinic patients in New Mexico. Participants were randomized to either a usual-care condition (a skin cancer pamphlet) or an MC1R test offer. Analysis included the 499 participants (44 percent white; 48 percent Hispanic) randomized to the MC1R test offer. The offer included a login for the study website, which required reading three educational modules showing the rationale, benefits, and drawbacks of MC1R testing. Those without Internet access were also offered the opportunity to view the information via paper forms. Uptake was measured for three stages: website log on, saliva test kit request, and return of the saliva test kit.

The researchers found that 46 percent logged onto the website to learn more about MC1R testing (with 18 of the 232 participants using a paper form). Of those who logged on, 88 percent requested a test kit and of those 82 percent returned the kit. The strongest predictors of website log on were race/ethnicity (non-Hispanic whites were more likely to log on) and education (highly educated individuals were more likely versus those not completing high school). However, the strongest predictor of ordering the test was sunburn history.

"More research is needed to explore barriers to genomic testing among racially and ethnically diverse and less educated patients, including lack of knowledge, lower genomic literacy, and lack of confidence in the medical system, to achieve maximum benefits of precision prevention for skin cancer and other chronic diseases in the broad population who stand to benefit from such technologies," write the authors led by Jennifer Hay, Ph.D., from Memorial Sloan Kettering Cancer Center (New York).

Takeaway: There is evidence that genetic risk testing for skin cancer is acceptable to the general population, but efforts are needed to ensure uptake does not further promote health disparities.

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