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The Association between Race and Attitudes about Predictive Genetic Testing

¹ Department of Medicine and ² Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA; and ³ Abramson Cancer Center and ⁴ Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA

Requests for reprints: Katrina Armstrong, Department of Medicine, University of Pennsylvania, 1204 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021. Phone: (215) 898-0957; Fax: (215) 573-8778. E-mail: karmstro{at}mail.med.upenn.edu

Objective: To investigate differences in attitudes about predictive genetic testing for cancer risk between African-American and Caucasian residents of the city of Philadelphia. Methods: Cross-sectional survey of awareness of and attitudes about predictive genetic testing, using an instrument developed through focus groups with the general public, literature review, and expert opinion. Setting: Municipal County Courthouse of Philadelphia. Respondents: Male and female adults waiting to be assigned to jury duty. Results: Of the 430 respondents, 43% (170) were African-American and 45% (181) Caucasian. Awareness of predictive genetic testing was higher among Caucasians (72%) than African-Americans (49%). After adjustment for age, gender, and educational attainment, African-Americans were more likely to report that the government would use genetic tests to label groups as inferior, and less likely to endorse the potential health benefits of testing, including "help my doctor manage my health care," "help me change my lifestyle," and "help scientists find cures for diseases." These associations remained if the sample was restricted to participants who had heard of genetic testing before the survey. Conclusions: In the city of Philadelphia, awareness of and attitudes about predictive genetic testing for cancer risk differ by race, with lower awareness, less belief in the potential benefits of testing, and more concern about racial discrimination from genetic testing among African-Americans than Caucasians. These differences may result in disparities in the uptake of predictive genetic testing in the future.

Key Words: genetic testing • general public • African-American • attitudes

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