OBJECTIVES:   As the potential role of genetic testing in disease prevention and management grows, so does concern about differences in uptake of genetic testing across social and racial groups.  Characteristics of how genetic tests are delivered may influence willingness to undergo testing and potentially alter disparities in testing. METHODS: Conjoint analysis study of the effect of three characteristics of genetic test delivery on willingness to undergo genetic testing for cancer risk. Data were collected using a random digit dialing survey of 337 individuals living in the US. Measures included conjoint scenarios, health care system distrust (values and competence subscales), health insurance coverage, and sociodemographic characteristics. Three attributes were studied: disclosure of test results to the health insurer, provision of the test by a specialist or primary care doctor, race specific or race neutral marketing. RESULTS: In adjusted analyses, disclosure of test results to insurers, having to get the test from a specialist, and race specific marketing were all inversely associated with willingness to undergo the genetic test, with the greatest effect for the disclosure attribute.  Racial differences in willingness were not statistically significant (p=0.07) and the effect of the attributes on willingness to undergo testing did not vary by patient race. However, the decrease in willingness with insurance disclosure was greater among individuals with high values distrust (p=0.03) and the decrease in willingness to undergo testing from specialist access was smaller among individuals with high competence distrust (p=0.03).   CONCLUSIONS: Several potentially modifiable characteristics of how genetic tests are delivered are associated with willingness to undergo testing.  The effect of two of these vary according to the level of health care system distrust, suggesting that policy decisions about delivery of genetic testing may influence differences in uptake across patient subgroups defined by levels of distrust rather than by race.