Guertler Diana, Reinhard Ann-Kristin, Ulbricht Sabina, Chenot Jean-François, Felbor Ute, Wurm Susanne
Department of Methods of Community Medicine, Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany.
Fam Med Community Health. 2025 Jul 31;13(3):e003395. doi: 10.1136/fmch-2025-003395.
This study describes acceptance and attitudes towards genetic cancer testing among German primary care patients.
Cross-sectional survey.
Primary care.
Systematically recruited patients aged ≥18 years from six general practices in Mecklenburg-Western Pomerania participated in an anonymous self-administered survey on familial cancer prevention (n=479 and 67.0% participation rate). Those with complete data were analysed (n=424; mean age 53.7, SD 16.6 years; men 34.4%). Linear regression analyses were used to examine potential disparities in general acceptance of genetic testing and attitudes towards genetic cancer testing according to sociodemographics and familial cancer knowledge.
General acceptance of genetic testing was high, particularly among younger, higher-educated individuals and those with a family history of cancer and higher familial cancer knowledge. For example, 83.3% either agreed or strongly agreed that it should be available to anybody. The most important benefits of genetic cancer testing were to guide check-up frequency (81.4%), to inform medical decision-making (80.2%) and to understand children's risk (75.2%). The most important concerns included the potential burden on the family (44.6%) and the belief that cancer cannot be prevented (39.2%). More favourable attitudes were found among younger, higher-educated individuals, those with a personal history of cancer and those with fewer children or no partner. For example, higher age was linked to lower benefit (regression coefficient (RC) -0.01, 95% CI -0.01 to -0.001) and higher concern ratings (RC 0.01, 95% CI 0.002 to 0.01). About a third (34.7%) rated not wanting to know about genetic alterations that increase their cancer risk as a (very) important reason against testing. Information avoidance was higher among older individuals (RC 0.02, 95% CI 0.01 to 0.02), women (RC 0.40, 95% CI 0.11 to 0.69), those with lower education (RC -0.64, 95% CI -0.91 to -0.36) and those with more children (RC 0.21, 95% CI 0.09 to 0.33).
Acceptance of genetic testing was high, but barriers remain, particularly among older adults, women, the less educated and those with more children. Targeted educational efforts to improve health literacy, emphasise the preventive potential of genetic testing and emotional support through genetic counselling are essential to overcome these barriers and promote informed decision-making.
本研究描述了德国初级保健患者对遗传性癌症检测的接受程度和态度。
横断面调查。
初级保健机构。
从梅克伦堡-前波美拉尼亚州的6家普通诊所中系统招募的年龄≥18岁的患者参与了一项关于家族性癌症预防的匿名自填式调查（n = 479，参与率67.0%）。对数据完整的患者进行分析（n = 424；平均年龄53.7岁，标准差16.6岁；男性占34.4%）。采用线性回归分析，根据社会人口统计学和家族性癌症知识，研究遗传性检测总体接受度和对遗传性癌症检测态度方面的潜在差异。
对遗传性检测的总体接受度较高，尤其是在年轻、高学历个体以及有癌症家族史和较高家族性癌症知识的人群中。例如，83.3%的人同意或强烈同意应向任何人提供检测。遗传性癌症检测最重要的益处是指导检查频率（81.4%）、为医疗决策提供信息（80.2%）以及了解子女的患病风险（75.2%）。最重要的担忧包括对家庭的潜在负担（44.6%）以及认为癌症无法预防（39.2%）。在年轻、高学历个体、有个人癌症史的个体以及子女较少或没有伴侣的个体中，态度更为积极。例如，年龄越大，认为检测有益的比例越低（回归系数（RC）-0.01，95%置信区间-0.01至-−0.001），担忧程度评分越高（RC 0.01，95%置信区间0.002至0.01）。约三分之一（34.7%）的人将不想知道增加其癌症风险的基因改变作为反对检测（非常）重要的理由。老年人（RC 0.02，95%置信区间0.01至0.02）、女性（RC 0.40，95%置信区间0.11至0.69）、低学历者（RC -0.64，95%置信区间-0.91至-0.36）以及子女较多的人（RC 0.21，95%置信区间0.09至0.33）更倾向于回避信息。
对基因检测的接受度较高，但障碍仍然存在，尤其是在老年人、女性、低学历者和子女较多的人群中。有针对性地开展教育工作以提高健康素养、强调基因检测的预防潜力并通过遗传咨询提供情感支持，对于克服这些障碍和促进明智决策至关重要。
