Cigarette Smoking During Recovery From Substance Use Disorders.

Genetic testing for hereditary cancer predisposition offers several avenues for targeted prevention, early detection, treatment and survivorship care among those identified as high risk. Germline genetic testing enables individuals to determine whether they carry a pathogenic variant in a gene that increases their risk of developing cancers such as breast, colon, and prostate cancer. Genetic testing is often facilitated via a genetic counselor or directly ordered by a patient’s health care primary- or oncology-care provider. Detecting the presence of a pathogenic variant (i.e., a mutation) informs options for risk management through surgical or medical interventions or more frequent screenings. Importantly, genetic testing of an individual (i.e., the proband) can also inform testing decisions for at-risk relatives through cascade testing whereby additional family members are tested for the germline pathogenic variant identified in the proband. Despite clinical practice guidelines designed to help identify individuals eligible for genetic testing and risk management options, access to and uptake of genetic testing remain low, particularly among low income and racial/ethnic minority individuals. These differences can be attributed to a constellation of factors across multiple levels spanning the community, health care system, provider, and the individual themselves. At the individual level, awareness of testing may serve as a key barrier to uptake of testing among those who can potentially benefit. The public’s awareness of cancer genetic testing has increased from 44% in 2000, to 47% in 2010, to about 48% in 2020. Awareness of of genetic testing increased from 57% in 2017, to 75% in 2020, to 81% in 2022. The proportion of individuals who reported having undergone of genetic testing nearly doubled over a two-year period (i.e., from 19% in 2020 to 40% in 2022). As the public becomes increasingly aware of and utilizes genetic testing, there is a need to monitor factors related to awareness and engagement and to further understand information needs. Kaphingst and colleagues posited that genetic communication is a continuum whereby baseline awareness and understanding of genetic testing is the for communication, leading to uptake-related decisions (e.g., whether or not to have genetic testing), to understanding results (e.g., interpreting risk), to ultimately making decisions about the results (e.g., treatment decisions, psychological impact). Thus, to improve genetic testing communication, it is important to first understand correlates of awareness, uptake, and information needs (e.g., desire to know about a genetic mutation), which are constructs across phases of the communication continuum.