Anticipating dissemination of cancer genomics in public health: A theoretical approach to psychosocial and behavioral challenges

摘要

Background: Given the recent sequencing of the human genome, genetic susceptibility information will probably be increasingly useful in the prevention and control of many common diseases, including cancer.Purpose: Although much is known about psychosocial factors related to the impact of cancer genetic testing among high-risk families in specialized clinic settings, much less is known about how genetic susceptibility information may contribute to the health and wellbeing of the general population.Methods: We present a theoretical synthesis drawn from the health communication and health behavior change traditions to guide research examining psychosocial and behavioral challenges central to dissemination of cancer genomics in public health.Results: These challenges include (a) anticipating individuals’ reactions to receiving genetic information that is probabilistic and derived from multiple sources; (b) modeling the influence of public communication about genetics on the population; (c) confronting the need to disseminate cancer genomic information through public health channels; and (d) maximizing opportunities to achieve cancer risk reduction across individuals, families, and local environments. Throughout the article, we use melanoma genomics as an example of the issues requiring attention.Conclusions: We hope the model helps shape the psychosocial and behavioral research agenda concerning the impact of cancer genomics outside the high-risk clinic.