Genetic Testing in Chinese Breast Cancer Patients: A Survey on Knowledge, Receipt, and Willingness to Pay

OBJECTIVES: The use of genetic testing among Chinese breast cancer patients has not been well studied. We aimed to investigate the genetic testing pattern including knowledge, test receipt, and willingness to pay for breast cancer patients in China.

METHODS: We investigated women from a breast cancer patient association about their genetic testing experiences in 2021. Multivariate logistic regression evaluated correlates of knowing about genetic testing, receipt of testing, and willingness for future test. We further identified predictors of a higher willingness to pay for genetic testing by multivariate linear regression.

RESULTS: A total of 604 patients were included in the final analysis with the mean age of 56.61 years. Around 41.89% reported knowing about genetic testing, which was more common in those more educated, reporting higher family income, and having non-Han ethnicity. About 12.42% reported test receipt, with likelihood higher in more educated patients and those with family history of breast or ovarian cancer. Around 60% of the untested patients expressed their willingness for future test, especially in younger patients or those with younger menarche age. The estimated willingness to pay for genetic testing was around $460 (CNY 3,000) and higher in employed, more educated, and nulliparous patients.

CONCLUSIONS: Genetic testing uptake was relatively low among Chinese breast cancer patients considering the proportion of patients knowing about genetic testing and willing to be tested, with a willingness to pay of $460. Well-educated, employed, and wealthy patients, together with those with cancer family history or other risk factors (early age at menarche and nulliparity) tended to have better access to or a higher willingness to pay for genetic testing. Targeted interventions are warranted to remove barriers to genetic services for those underrepresented, and facilitate informed decision-making on the appropriate use of genetic testing in Chinese breast cancer patients.