ELSIcon2022 Flash: Patients’ expectations of benefits from large-panel genomic tumor testing in rural community oncology practices

ELSIcon2022 • Flash • June 3, 2022

Eric Anderson, Paul Han

Large-panel genomic tumor testing (GTT) is a new technology that promises to make cancer treatment more precise. However, GTT also has uncertain utility for individual patients. Because GTT is new and complex, patients may not understand it well and have unrealistic expectations they will benefit. Overly optimistic expectations could lead to poor decision making not aligned with patient values.

Patients with cancer enrolled in a large initiative to disseminate GTT in community oncology practices completed surveys assessing their expectations, knowledge, and attitudes about GTT. The study sample (N = 1,139) consisted of patients with a range of cancer types and cancer stages. 71% had no college degree; 57% came from households with less than $50,000 US dollars household income; and 73% lived in rural areas.

Generally, patients had high expectations that they would benefit from GTT (M = 2.81 on 0-4 scale) and positive attitudes toward it (M = 2.98 on 0-4 scale). Patients also had relatively poor knowledge about GTT (48% correct answers on an objective test of GTT knowledge). Greater expectations for GTT were associated with lower knowledge (b = –0.46; p < .001), more positive attitudes (b = 0.40; p < .001), and lower education (b = –0.53; p < .001).
This research suggests patients have overly optimistic expectations that they will benefit from GTT, which is associated with low knowledge, positive attitudes, and low education. More research is needed to understand the effects of these expectations, and the concordance between expectations and actual clinical outcomes.