Socioeconomic Status and Interest in Pursuing Genetic Testing for Hereditary Cancer in a US Based Population

Abstract

Cancer is a significant burden to individuals and to the U.S. healthcare system (ACS, 2018).Individuals of low socioeconomic status (SES) have increased mortality and incidence of all types of cancers (Singh & Jemal, 2017). Genetic testing for hereditary cancers can provide information about an individual’s risk of developing cancer and guide future screening and preventative services for themselves and their relatives (Sandler, Alfino, & Saleem, 2018). However, there are financial barriers to both meeting with a genetics professional and having genetic testing, particularly for those who make a low income or have limited or no insurance coverage. This study used the Early Detection of GEnetic Risk (EDGE) Study’s patient baseline survey to evaluate the relationship between socioeconomic status and interest in pursuing hereditary cancer genetic testing, as well as data from Medicare Coverage Database and genetic testing companies’ financial assistance programs (FAPs) to examine what financial assistance exists for individuals pursuing genetic testing. Results showed a strong relationship between all SES and demographic measures and interest in pursuing genetic testing, excluding race and ethnicity. For Medicare to cover the cost of genetic testing for many of the genes, patients must already have symptoms of cancer. Medical and financial criteria a patient must meet to qualify for FAPs is often unclear and inconsistent between companies. If genetic testing is the future of preventative medicine, more work needs to be done to provide these to low-SES groups and to ensure that those services are used by the most vulnerable populations.