title: Genomic testing in cancer: patient knowledge, attitudes, and expectations.
abstract: BACKGROUND
  Genomic testing in cancer (GTC) characterizes genes that play an important role in the development and growth of a patient's cancer. This form of DNA testing is currently being studied for its ability to guide cancer therapy. The objective of the current study was to describe patients' knowledge, attitudes, and expectations toward GTC.
  
  
  METHODS
  A 42-item self-administered GTC questionnaire was developed by a multidisciplinary group and patient pretesting. The questionnaire was distributed to patients with advanced cancer who were referred to the Princess Margaret Cancer Center for a phase 1 clinical trial or GTC testing.
  
  
  RESULTS
  Results were reported from 98 patients with advanced cancer, representing 66% of the patients surveyed. Seventy-six percent of patients were interested in learning more about GTC, and 64% reported that GTC would significantly improve their cancer care. The median score on a 12-item questionnaire to assess knowledge of cancer genomics was 8 of 12 items correct (67%; interquartile range, 7-9 of 12 items correct [58%-75%]). Scores were associated significantly with patients' education level (P < .0001). Sixty-six percent of patients would consent to a needle biopsy, and 39% would consent to an invasive surgical biopsy if required for GTC. Only 48% of patients reported having sufficient knowledge to make an informed decision to pursue GTC whereas 34% of patients indicated a need for formal genetic counseling.
  
  
  CONCLUSIONS
  Patients with advanced cancer are motivated to participate in GTC. Patients require further education to understand the difference between somatic and germline mutations in the context of GTC. Educational programs are needed to support patients interested in pursuing GTC.
authors: Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors: Phillip S
authors: PS
authors: Blanchette
authors: Anna
authors: A
authors: Spreafico
authors: Fiona A
authors: FA
authors: Miller
authors: Kelvin
authors: K
authors: Chan
authors: Jessica
authors: J
authors: Bytautas
authors: Steve
authors: S
authors: Kang
authors: Philippe L
authors: PL
authors: Bedard
authors: Andrea
authors: A
authors: Eisen
authors: Larissa
authors: L
authors: Potanina
authors: Jack
authors: J
authors: Holland
authors: Suzanne
authors: S
authors: Kamel-Reid
authors: John D
authors: JD
authors: McPherson
authors: Albiruni R
authors: AR
authors: Razak
authors: Lillian L
authors: LL
authors: Siu
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D032882:Comprehension; D003657:Decision Making; D005260:Female; D005817:Genetic Counseling; D005820:Genetic Testing; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000235:genetics*; D009864:Ontario; D010361:Patients / Q000706:statistics & numerical data*; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: attitude; cancer; genomic testing; knowledge