title: The Impact of Receiving Predictive Genetic Information about Lynch Syndrome on Individual Colonoscopy and Smoking Behaviors.
abstract: This study investigated whether receiving the results of predictive genetic testing for Lynch syndrome, indicating the presence or absence of an inherited predisposition to various cancers, including colorectal cancer, was associated with change in individual colonoscopy and smoking behaviors, which could prevent colorectal cancer.
  
  
  
  The study population included individuals with no previous diagnosis of colorectal cancer, whose families had already identified deleterious mutations in the mismatch repair or EPCAM genes. Hypotheses were generated from a simple health economics model and tested against individual-level panel data from the Australasian Colorectal Cancer Family Registry.
  
  
  
  The empirical analysis revealed evidence consistent with some of the hypotheses, with a higher likelihood of undergoing colonoscopy in those who discovered their genetic predisposition to colorectal cancer and a lower likelihood of quitting smoking in those who discovered their lack thereof.
  
  
  
  Predictive genetic information about Lynch syndrome was associated with change in individual colonoscopy and smoking behaviors but not necessarily in ways to improve population health.
  
  
  
  The study findings suggest that the impact of personalized medicine on disease prevention is intricate, warranting further analyses to determine the net benefits and costs. Cancer Epidemiol Biomarkers Prev; 25(11); 1524-33. ©2016 AACR.
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. joanne.kim@mail.utoronto.ca.|Canadian Centre for Health Economics, Toronto, Canada.
authors.forename: Joanne Soo-Min
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.|Canadian Centre for Health Economics, Toronto, Canada.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Coyte
authors.affiliation: Prevention and Cancer Control, Cancer Care Ontario, Toronto, Canada.
authors.forename: Michelle
authors.initials: M
authors.lastname: Cotterchio
authors.affiliation: Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
authors.forename: Louise A
authors.initials: LA
authors.lastname: Keogh
authors.affiliation: Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Australia.
authors.forename: Louisa B
authors.initials: LB
authors.lastname: Flander
authors.affiliation: Department of Paediatrics, University of Melbourne, Melbourne, Australia.|Department of Medicine, University of Melbourne, Melbourne, Australia.
authors.forename: Clara
authors.initials: C
authors.lastname: Gaff
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.|Canadian Centre for Health Economics, Toronto, Canada.
authors.forename: Audrey
authors.initials: A
authors.lastname: Laporte
mesh_terms: D000328:Adult; D000368:Aged; D003113:Colonoscopy; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000235:genetics* / Q000517:prevention & control / Q000523:psychology; D053843:DNA Mismatch Repair; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D057285:Precision Medicine; D012907:Smoking