Psychosocial and behavioral outcomes of genomic testing in cancer: a systematic review

Abstract

Psychosocial and behavioral outcomes of genetic testing in oncology are well known, however, it is unclear how these findings will generalize to more complex genomic testing. The aim of this systematic review was to assess the psychosocial and behavioral outcomes of cancer genomic testing. Studies were selected for inclusion if they were published from January 2003 to January 2017 and addressed psychological and behavioral outcomes of cancer genomic testing in adults. A review of four databases identified 9620 abstracts, with 22 publications meeting the inclusion criteria. Of the included articles, 11 studies reported on outcomes of germline testing, with three articles assessing panel testing and eight SNP testing. No studies assessed the outcomes of WGS or WES. Eleven articles assessed the outcomes of somatic testing, including testing for cancer prognosis and for personalized therapies. Studies were biased toward breast cancer and Caucasian women with high education and socioeconomic status. While studies demonstrated limited adverse psychological outcomes associated with genomic testing, a lack of consistency in psychosocial measures precluded any meta-analysis. Changes in health behavior following positive results were limited, and in some cases risk perception was not altered following genomic testing. There is limited evidence of adverse psychosocial outcomes and changes in health behavior following genomic testing to assess cancer risk. Findings from this review highlight the need for longitudinal research with superior methodological and theoretical design.

Exploring the emotional and behavioural reactions to receiving personalized melanoma genomic risk information: a qualitative study

“…We found that many participants experienced positive emotional reactions to receiving their risk results, similarly to other genetic testing studies . Sanderson et al .…”

“…Personal genomic testing is increasingly being offered in clinical, research and commercial contexts. [1][2][3][4][5][6] The mainstreaming of genomic testing offers the possibility of providing personalized risk information for common, polygenic diseases such as melanoma on a population-wide scale. 7,8 With strong evidence that the incidence and prognosis of melanoma are associated with sun protection and skin examination, [9][10][11] the provision of personalized melanoma genomic risk information to the general population is a potential strategy to improve melanoma prevention and screening behaviours.…”

“…Studies to date suggest personal genomic testing has little emotional impact and only at best, a small effect on eliciting positive healthrelated behaviours. 2,5,6,12 However, the quality of the research evidence is limited, and there is a lack of evidence on skin cancer prevention and screening behaviours. Offering genomic testing for diseases with modifiable risk factors such as melanoma, alongside education and lifestyle counselling, may also yield different outcomes than previously reported when providing risk information alone.…”

“…Personal genomic testing is increasingly being offered in clinical, research and commercial contexts . The mainstreaming of genomic testing offers the possibility of providing personalized risk information for common, polygenic diseases such as melanoma on a population‐wide scale .…”

“…There is debate over the clinical and personal utility of personal genomic testing for healthy individuals. Studies to date suggest personal genomic testing has little emotional impact and only at best, a small effect on eliciting positive health‐related behaviours . However, the quality of the research evidence is limited, and there is a lack of evidence on skin cancer prevention and screening behaviours.…”