Department of Health Policy and Management, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.
Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas.
Am J Prev Med. 2018 Jun;54(6):806-813. doi: 10.1016/j.amepre.2018.02.013. Epub 2018 Apr 12.
Direct-to-consumer genetic tests for inherited disease risks have gained recent approvals from the Food and Drug Administration, and interest in these tests has continued to grow. Broad use of these tests coupled with planning and discussion with health providers regarding genetic risks and potential protective behavior changes have been proposed as preventive tools to reduce health disparities and improve equity in health outcomes. However, awareness of direct-to-consumer genetic testing has historically demonstrated differences by education, income, and race; these disparities could jeopardize potential benefits by limiting access and use.
The national survey data from the Health Information National Trends Survey was analyzed to understand how overall awareness of direct-to-consumer genetic testing and disparities in awareness across sociodemographic groups have changed since 2007.
The findings showed persistent disparities, as well as a widening gap in awareness between Hispanics and non-Hispanic whites (OR =1.52, OR =0.58, p =0.0056), despite overall increases in awareness over time.
Given these findings, policies regulating direct-to-consumer genetic tests should prioritize equitable distribution of benefits by including provisions that counteract prevailing disparities in awareness.
直接面向消费者的遗传疾病风险检测已获得美国食品和药物管理局(FDA)的最新批准,人们对这些检测的兴趣也在持续增长。广泛使用这些检测,并与医疗服务提供者一起规划和讨论遗传风险以及潜在的保护性行为改变,被提议作为减少健康差距和改善健康结果公平性的预防工具。然而,直接面向消费者的遗传检测意识在历史上表现出了受教育程度、收入和种族的差异;这些差异可能会通过限制获取和使用来危及潜在的益处。
本研究分析了来自全国健康信息趋势调查(Health Information National Trends Survey)的全国性调查数据,以了解自 2007 年以来,人们对直接面向消费者的遗传检测的总体意识以及在社会人口统计学群体中的差异是如何变化的。
研究结果显示,尽管随着时间的推移,人们的意识总体上有所提高,但仍存在持续的差异,以及西班牙裔和非西班牙裔白人之间的意识差距不断扩大(OR=1.52,OR=0.58,p=0.0056)。
鉴于这些发现,监管直接面向消费者的遗传检测的政策应通过纳入抵消现有意识差异的条款,优先考虑公平分配利益。