Racial Disparity and Awareness of Disease-Risk Genetic Testing: A Nationwide Sampling Survey Analysis

OBJECTIVES: This study aimed to examine the race/ethnicity disparity in disease-risk genetic testing (DRGT) awareness in the United States and further identify the factors associated with DRGT awareness among race/ethnicity groups.

METHODS: A retrospective cross-sectional survey study was conducted using 2022 Health Information National Trends Survey data. Descriptive analyses were performed among the participants with and without DRGT awareness. Survey-weighted logistic regressions with stepwise model selection were used to identify the factors influencing awareness of DRGT. Further, factors related to DRGT among different race/ethnicity groups were identified.

RESULTS: Among 5968 responders, 52.6% were aware of DRGT. Participants with DRGT awareness are younger, more female, white, with higher education, higher household income, more likely to have insurance, regular provider, internet access, and a family history of cancer. Perceived genetic susceptibility, worry about cancer, and perceived progress of cancer treatment and prevention are higher among those with awareness. (All p-value<0.05)

Compared with non-Hispanic white participants, Hispanic, non-Hispanic African American (nH-AA), and Asian American and Pacific Islander (AAPI) participants were less likely to have DRGT awareness (adjusted-OR 0.49, 0.53, and 0.40, respectively, all p-values < 0.05).

Significant factors influencing DRGT awareness included age, race, education, family cancer history, and perceptions of the importance of genetics for cancer prevention. These factors varied among racial/ethnic groups. For nH-White, age, regular provider visits, and family cancer history were significant. Among Hispanics, education, fatalistic beliefs, and cancer worry were significant factors. nH-AA showed significance in access to the internet and family cancer history. No statistically significant factors were observed for AAPI.

CONCLUSIONS: Disparities in DRGT awareness exist, particularly among AAPI and their white counterparts. Age, race, education, family cancer history, and perceptions of genetic and cancer prevention significantly impact DRGT awareness, and these factors differ among racial/ethnic groups. Addressing these differences is crucial in developing targeted promotion strategies.