Table 3.
Associations of Family History and Other Characteristics with Knowledge and Use of Genetic Testing for Cancer
| Heard of genetic test | Physician discussed genetic test | Physician advised genetic test | Received genetic test | |
|---|---|---|---|---|
| OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |
| Number of first-degree relatives or subject with a BRCA- or Lynch-associated cancer (age of onset) | ||||
| None | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| 1 (age ≥50 years) | 1.26 (1.13–1.40) | 2.74 (2.03–3.70) | 1.49 (0.82–2.71) | 1.95 (1.12–3.38) |
| 1 (age <50 years) | 1.30 (1.15–1.48) | 2.80 (2.11–3.73) | 1.50 (0.84–2.68) | 2.98 (1.77–5.01) |
| ≥2 | 1.40 (1.17–1.68) | 4.05 (2.67–6.16) | 1.58 (0.80–3.14) | 2.72 (1.45–5.11) |
| Sex | ||||
| Female | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Male | 0.71 (0.66–0.75) | 0.73 (0.58–0.91) | 0.68 (0.45–1.02) | 0.95 (0.65–1.38) |
| Age (years) | ||||
| 18–39 | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| 40–49 | 1.16 ( 1.06–1.27) | 0.80 ( 0.63–1.00) | 1.0 (0.63–1.59) | 0.86 (0.54–1.38) |
| 50–59 | 1.23 (1.12–1.35) | 0.60 (0.45–0.81) | 1.27 (0.75–2.15) | 0.51 (0.29–0.91) |
| 60–69 | 1.13 (1.01–1.28) | 0.45 (0.30–0.67) | 0.69 (0.32–1.47) | 0.48 (0.23–1.00) |
| ≥70 | 0.56 (0.49–0.63) | 0.30 (0.19–0.48) | 0.97 (0.44–2.16) | 0.41 (0.18–0.93) |
| Race/ethnicity | ||||
| White, non-Hispanic | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Hispanic | 0.48 (0.42–0.54) | 2.33 (1.68–3.25) | 3.37 (1.59–7.14) | 4.73 (2.78–8.03) |
| African American, other non-Hispanic | 0.59 (0.54–0.65) | 1.39 (1.08–1.78) | 1.03 (0.57–1.88) | 1.65 (0.99–2.74) |
| Education | ||||
| Less than high school grad | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| High school grad | 1.50 (1.33–1.68) | 0.83 (0.55–1.24) | 1.28 (0.63–2.60) | 0.84 (0.45–1.55) |
| Some college | 2.59 (2.32–2.90) | 0.69 (0.46–1.03) | 0.74 (0.36–1.51) | 0.74 (0.40–1.39) |
| College grad | 4.42 (3.95–4.95) | 0.89 (0.62–1.29) | 0.98 (0.48–1.98) | 0.89 (0.50–1.59) |
| Married or living with partner | ||||
| No | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Yes | 1.14 (1.07–1.22) | 0.98 (0.81–1.20) | 0.76 (0.52–1.13) | 0.96 (0.66–1.40) |
| Body mass index | ||||
| Underweight/normal | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Overweight | 1.02 (0.95–1.10) | 1.01 (0.79–1.29) | 1.42 (0.90–2.25) | 1.34 (0.89–2.00) |
| Obese | 0.95 (0.87–1.03) | 0.95 (0.73–1.24) | 1.61 (1.00–2.61) | 1.57 (0.96–2.59) |
| Self-perceived poor health | ||||
| No | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Yes | 0.74 (0.67–0.82) | 1.23 (0.90–1.67) | 1.05 (0.60–1.83) | 1.84 (1.18–2.88) |
| No. comorbid conditions | ||||
| None | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| 1 | 1.28 (1.18–1.38) | 1.21 (0.97–1.52) | 1.55 (0.98–2.45) | 1.12 (0.71–1.78) |
| 2 | 1.42 (1.28–1.58) | 1.07 (0.79–1.44) | 1.81 (0.99–3.32) | 0.83 (0.44–1.54) |
| ≥3 | 1.33 (1.18–1.51) | 0.79 (0.51–1.21) | 1.24 (0.59–2.63) | 0.76 (0.38–1.52) |
| Personal history of cancer | ||||
| No cancer | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| BRCA-/Lynch-associated cancera | 1.03 (0.86–1.24) | 2.48 (1.60–3.83) | 2.33 (1.16–4.69) | 6.72 (3.56–12.67) |
| Other cancer | 1.28 (1.11–1.48) | 2.47 (1.74–3.52) | 2.93 (1.44–5.97) | 4.19 (2.24–7.84) |
| Current smoker | ||||
| No | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Yes | 0.97 (0.89–1.06) | 1.06 (0.82–1.36) | 1.01 (0.64–1.61) | 0.87 (0.54–1.41) |
| US born | ||||
| No | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Yes | 1.67 (1.48–1.87) | 0.99 (0.72–1.36) | 1.10 (0.54–2.28) | 1.39 (0.80–2.40) |
| US region | ||||
| South | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Northeast | 1.25 (1.12–1.39) | 1.31 (0.97–1.77) | 1.47 (0.82–2.64) | 1.34 (0.80–2.22) |
| Midwest | 1.29 (1.18–1.42) | 1.17 (0.90–1.53) | 0.89 (0.54–1.45) | 1.39 (0.89–2.17) |
| West | 1.28 (1.17–1.40) | 1.36 (1.07–1.73) | 1.07 (0.67–1.71) | 1.19 (0.73–1.94) |
aCancers included: breast, ovarian (BRCA), colorectal, uterine (Lynch)