Assessing relatives’ readiness for hereditary cancer cascade genetic testing

Abstract

Purpose: To explore the readiness of living, untested first-degree relatives (FDRs) to have cascade genetic testing (CGT) for a hereditary predisposition to cancer. Methods: Adults with a hereditary predisposition to cancer completed an anonymous, online survey about their genetic testing and their FDRs’ vital status, awareness of the variant, uptake of CGT, and readiness for CGT among living, untested FDRs using transtheoretical model stages of change. Results: One hundred fifty participants completed the survey and reported 825 FDRs. Overall, 70.3% of FDRs were reportedly aware of the variant and 30.5% had completed CGT. Siblings had higher rates of awareness and CGT than parents or children (p < 0.001). Relatives’ sex was associated with awareness and CGT; mothers were aware and had CGT at higher rates than fathers (p = 0.049 and p < 0.001), sisters were aware and had CGT at higher rates than brothers (p = 0.041 and p = 0.002), and daughters had higher rates of awareness than sons (p = 0.038). Of 340 living, untested FDRs, 79.4% were in the precontemplation stage of change, with no difference by relatives’ sex or relationship to the participant. Conclusions: Most living, untested FDRs were in precontemplation stage, indicating they are not ready or planning to have CGT within the next six months.