OBJECTIVES: This study aimed to examine the race/ethnicity disparity in disease-risk genetic testing (DRGT) utilization and post-test result sharing and health behavior changes in the United States and identify associated factors.

METHODS: A retrospective cross-sectional survey study was conducted using 2022 Health Information National Trends Survey (HINTS) data. Survey-weighted descriptive analyses and logistic regressions with stepwise model selection were used to identify the factors for disease-risk genetic testing utilization and post-test results sharing and behavior change. Further, risk factors among different race/ethnicity groups were identified, respectively.

RESULTS: Among 4586 responders, 14.3% underwent DRGT. Post-DRGT, 91% shared results: 57.9% with healthcare providers or genetic counselors (HCP/GC), 50.2% with a spouse and 61.5% with a first degree relative (FDR). Among DRGT users, 42.8% reported post-test behavior changes including lifestyle modifications dietary supplement adjustments (13.9%), medication changes (10%), and increased health screenings (14.6%).

Participants with DRGT were more likely to be older , female, white, have a regular provider and a family history of cancer. Participants with DRGT has higher proportion of having perceived genetic worry about cancer, and perceived progress of cancer treatment. (All p-values <0.05). Compared with non-Hispanic white (nH-White) participants, non-Hispanic African American (nH-AA) (adjusted-OR=1.78, p-value=0.01) and Hispanic participants (adjusted-OR=1.31, p-value=0.28) are more likely and Asian American and Pacific Islander (AAPI) participants were less likely to have DRGT (adjusted-OR= 0.37, p-values=0.03). DRGT risk factors varied by race/ethnicity.

Race/ethnicity disparity exists in the post-test results sharing. nH-AA and Hispanic participants are less likely to share results with HCP/GC (adjusted-OR=0.38, 0.50, p-value<0.05) than nH-White. Having a regular provider was strongly associated with result-sharing with HCP/GC and FDR (adjusted-OR=7.3, 4.7, respectively, p-value<0.05). Interestingly, race/ethnicity was not a significant factor for post-test behavior changes.

CONCLUSIONS: There are disparities in DRGT utilization and post-test behavior. Addressing these differences is crucial for reducing disparities and developing targeted promotion strategies