ELSIcon2022 Flash: Socioeconomic Status and Interest in Pursuing Genetic Testing for Hereditary Cancer in a US Based Population

ELSIcon2022 • Flash • June 3, 2022

Presented by: EJ Dusic

Deborah J. Bowen, Robin Bennett, Tesia Theoryn, Kevin C. Cain, Elizabeth Swisher, Jeannine Brant, Brian Shirts, Catharine Wang

Cancer is a significant burden, particularly to individuals of low socioeconomic status (SES) who have increased cancer incidence and mortality. Genetic testing for cancers provides information about risk of developing cancer and guides future preventative care. However, there are significant financial barriers, particularly for those who make low incomes or have limited or no insurance. This study used the Early Detection of GEnetic Risk (EDGE) Study’s baseline survey (n =2329) to evaluate the relationship between SES and interest in pursuing cancer genetic testing, as well as data from Medicare Coverage Database and genetic testing companies’ financial assistance programs (FAPs) to examine what financial assistance exists for individuals pursuing genetic testing. Results showed that low-income individuals have a 1.29 (95% CI: 1.02 – 1.63) greater odds of reporting high interest in genetic testing overall compared to high-income individuals. Conversely, individuals who score high on the scale of subjective social status have a 1.55 (95% CI: 1.09 – 2.21) greater odds of reporting high interest in genetic testing if the test was free or low cost. For Medicare to cover the cost of genetic testing for many of the eligible hereditary cancer genes, patients must already have a diagnosis of cancer. Medical and financial criteria a patient must meet to qualify for FAPs is unclear and inconsistent between companies. If genetic testing is the future of preventative medicine, work needs to be done to provide testing these to interested, low-SES groups and to ensure that those services are utilized by underserved populations.