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BMC Med Genomics. 2016 May 23;9(1):25. doi: 10.1186/s12920-016-0186-5.

Attitudes to incorporating genomic risk assessments into population screening programs: the importance of purpose, context and deliberation.

Author information

1
School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, K1H 8M5, Canada.
2
Clinical Epidemiology, Memorial University, St John's, NL, Canada.
3
Department of Family and Community Medicine, Sinai Health System, University of Toronto, Toronto, ON, Canada.
4
Sydney G. Frankfort Chair in Family Medicine, Toronto, ON, Canada.
5
Vice-President Research, University of Victoria, Victoria, BC, Canada.
6
School of Psychology, University of Ottawa, Ottawa, ON, Canada.
7
Michael G DeGroote National Pain Centre, McMaster University, Hamilton, ON, Canada.
8
School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, K1H 8M5, Canada. bwilson@uottawa.ca.

Abstract

BACKGROUND:

The use of an overall risk assessment based on genomic information is consistent with precision medicine. Despite the enthusiasm, there is a need for public engagement on the appropriate use of such emerging technologies in order to frame meaningful evaluations of utility, including the practical implementation and acceptability issues that might emerge. Doing so requires the involvement of the end users of these services, including patients, and sections of the public who are the target group for population based screening. In the present study we sought to explore public attitudes to the potential integration of personal genomic profiling within existing population screening programs; and to explore the evolution of these attitudes as part of a deliberative process.

METHODS:

We conducted a mixed methods study presented in the format of a deliberative workshop. Participants were drawn from communities in Ottawa, Ontario (ON) and St John's, Newfoundland and Labrador (NL), Canada. Individuals were approached to take part in a workshop on the incorporation of genomic risk profiling for either colorectal cancer screening (CRC), or newborn screening for type 1 diabetes mellitus (T1DM).

RESULTS:

A total of N = 148 (N = 65 ON, N = 83 NL) participants provided data for analysis. Participants in both groups were supportive of public funding for genomic risk profiling, although participants in the T1DM groups expressed more guarded positive attitudes than participants in the CRC groups. These views were stable throughout the workshop (CRC, p = 0.15, T1DM, p =0.39). Participants were less positive about individual testing, with a significant decrease in support over the course of the workshop (CRC p = 0.02, T1DM, p = 0.003). Common concerns related to access to test results by third parties.

CONCLUSIONS:

The findings of this study suggest that members of the target populations for potential genomic profiling tests (designed for screening or risk prediction purposes) can engage in meaningful deliberation about their general acceptability and personal utility. Evaluations of whether a test would be personally useful may depend on the experience of the participants in personal health decision making, the purpose of the test, and the availability of interventions to reduce disease risk.

PMID:
27215612
PMCID:
PMC4878078
DOI:
10.1186/s12920-016-0186-5
[Indexed for MEDLINE]
Free PMC Article

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