Clinician Discussion of Family Cancer Risk and Use of Genetic Testing Among US Adults With a Family History of Cancer.

INTRODUCTION

Family history plays a key role in assessing inherited cancer risk, but genetic testing is still underused at the population level. The role of clinician-patient discussion in this gap is not well characterized. This study aimed to evaluate the association between clinician discussion of family cancer risk and use of genetic testing among US adults with a first-degree family history of cancer.

METHODS

This cross-sectional study used data from the 2023 National Health Interview Survey. The exposure was self-reported clinician discussion of family cancer risk, and the outcome was self-reported receipt of genetic testing for cancer risk. Survey weights were applied to generate nationally representative estimates. Propensity scores were used to match respondents with and without clinician discussion. Survey-weighted logistic regression models estimated associations.

RESULTS

Among 9,476 respondents (representing approximately 72.6 million US adults), 50% reported clinician discussion, and 7.8% reported genetic testing. Testing was more common among those reporting discussion (12.9%) than those who did not (2.7%) (P < .001). In fully adjusted analyses, clinician discussion was associated with higher odds of testing (adjusted odds ratio, 5.35; 95% CI, 4.23-6.76). Older age, female sex, higher education, and personal cancer history were also associated with testing.

CONCLUSION

Clinician discussion of family cancer risk was strongly associated with use of genetic testing; however, overall testing rates were low. Improving routine clinician engagement may increase use of genetic services and support cancer prevention.