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Retention and Use of Breast Cancer Recurrence Risk Information from Genomic Tests: The Role of Health Literacy

¹ University of North Carolina at Chapel Hill, Chapel Hill, North Carolina and ² NIH, Bethesda, Maryland

Requests for reprints: Noel Brewer, School of Public Health, University of North Carolina at Chapel Hill, Rosenau Hall 306, CB #7440, Chapel Hill, NC 27599. Phone: 919-966-3282; Fax: 919-966-2921. E-mail: ntb1{at}unc.edu

Background: New genomic technology now allows physicians to provide women with individualized and highly accurate breast cancer recurrence risk estimates that are a key factor in adjuvant (after surgery) therapy decisions. Because these genomic tests are so new, little is known about how well patients understand the tests and their results.

Method: We interviewed 163 stage I or II breast cancer patients at a routine follow-up appointment. We assessed their health literacy (using the Rapid Estimate of Adult Learning in Medicine) as well as their knowledge of and attitudes towards a genomic test that identifies risk of recurrence in hormone receptor–positive, node–negative breast cancer (the OncoType Dx Recurrence Score).

Results: Women with lower health literacy recalled less of the information provided about the recurrence risk test than women with higher health literacy. Health literacy was not related to the amount of additional information women desired. Women with higher health literacy preferred to have a more active role in decisions about the test.

Implications: Health literacy may affect women's capacity to learn about the new genomic tests as well as their desire for informed participation in their medical care. (Cancer Epidemiol Biomarkers Prev 2007;16(2):249–55)

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