• BRCA;
  • cancer;
  • communication;
  • direct-to-consumer;
  • informed consent

Gray SW, Hornik RC, Schwartz JS, Armstrong K. The impact of risk information exposure on women's beliefs about direct-to-consumer genetic testing for BRCA mutations.

Despite an increase in direct-to-consumer (DTC) genetic testing, little is known about how variations in website content might alter consumer behavior. We evaluated the impact of risk information provision on women's attitudes about DTC BRCA testing. We conducted a randomized experiment; women viewed a ‘mock’BRCA testing website without [control group (CG)] or with information on the potential risks of DTC testing [RG; framed two ways: unattributed risk (UR) information and risk information presented by experts (ER)]. Seven hundred and sixty-seven women participated; mean age was 37 years, mean education was 15 years, and 79% of subjects were white. Women in the RG had less positive beliefs about DTC testing (mean RG = 23.8,CG = 25.2;p = 0.001), lower intentions to get tested (RG = 2.8,CG = 3.1;p = 0.03), were more likely to prefer clinic-based testing (RG = 5.1,CG = 4.8;p = 0.03) and to report that they had seen enough risk information (RG = 5.3,CG = 4.7;p < 0.001). UR and ER exposure produced similar effects. Effects did not differ for women with or without a personal/family history of breast/ovarian cancer. Exposing women to the potential risks of DTC BRCA testing altered their beliefs, preferences, and intentions. Risk messages appear to be salient to women irrespective of their chance of having a BRCA mutation.