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Qualitative study finds knowledge gaps and insurance concerns about prostate cancer genetic testingWhat stops men from getting genetic testing for prostate cancer?

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Key Takeaway
Note patient knowledge gaps and insurance concerns when discussing prostate cancer genetic testing.

This qualitative and survey study explored opinions, perceptions, expectations, and information needs regarding germline genetic testing for prostate cancer. Phase I involved focus group discussions with 20 men previously diagnosed with prostate cancer. Phase II involved reviewing a Precision Medicine in Prostate Cancer Information Toolkit with 14 patients, 4 carers/family members, and 14 healthcare providers.

Knowledge about precision medicine and genetic testing was generally low among participants. The strongest motivation for undertaking testing, reported by 7 participants, was to identify family members' risk levels. The biggest concern, reported by 5 participants, was insurance discrimination. Other concerns highlighted included implications for family and testing costs.

Healthcare providers (n=8) found the toolkit's purpose clearer than patients (n=5). Patients reported difficulty imagining the toolkit's usefulness at diagnosis or when assessing genetic risk beforehand. No safety or tolerability data were reported.

Key limitations include small sample sizes and the qualitative nature of the findings, which preclude causal inference. The study's practice relevance is that the toolkit may be helpful in addressing knowledge gaps, but the authors note further testing is needed to ensure its accessibility across different literacy and cultural contexts.

Genetic testing can reveal important information about prostate cancer risk, both for the man diagnosed and for his family. But a new study suggests many people are walking into this decision with significant gaps in their understanding. Researchers talked to a small group of men with prostate cancer, their family members, and their doctors to understand what they know and what worries them.

They found that knowledge about this type of medicine—called precision medicine—was generally low. The strongest reason people gave for wanting a genetic test was to understand the risk for their children and other relatives. However, the biggest concern holding them back was the fear that a positive result could lead to discrimination from life insurance companies.

To help, the researchers created an information toolkit. Doctors found its purpose clearer than patients did. Some patients struggled to imagine how they would have used this information when they were first diagnosed or when they were thinking about their genetic risk. The study was small and its findings are based on conversations and surveys, not on measuring health outcomes. The toolkit itself needs more testing to make sure it's accessible and helpful for people with different reading levels and cultural backgrounds.

What this means for you:
Fear of insurance discrimination is a major barrier to genetic testing for prostate cancer.

Study Details

Study typePhase2
Sample sizen = 20
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
BACKGROUND: Prostate cancer (PrCa) is the most commonly diagnosed cancer in men in many countries and is the most heritable of the common cancers. Precision medicine approaches to disease management are not routinely available to most men, yet we know that germline genetic testing can help identify those at high-risk of developing advanced or lethal disease and can influence selection of therapeutics. An integral part of healthcare delivery design is the inclusion of patients/consumers in the development of frameworks for managing health interventions that are tailored to meet their needs. METHODS: In Phase I, we undertook focus group discussions with men previously diagnosed with PrCa (n=20), to determine their opinions, perceptions and expectations of germline genetic testing for PrCa. Focus groups were tape-recorded, transcribed verbatim, coded and then thematically analysed using NVivo. In Phase II, themes were then used to design and development a Precision Medicine in Prostate Cancer Information Toolkit, which was reviewed by patients (n=14), their carers/family members (n=4) and healthcare providers (n=14). RESULTS: In Phase I, knowledge about precision medicine and genetic testing was generally low. The strongest motivation for undertaking testing was to identify family members' risk levels (n=7), and the biggest concern pertained to insurance discrimination (n=5). Phase II data revealed that generally healthcare providers (n=8) found the purpose of the toolkit to be clearer than patients (n=5). Though, patients found the task of imagining the usefulness of the toolkit at the time of diagnosis or beforehand when assessing genetic risk, quite difficult. Participants highlighted that information regarding life insurance, implications for their family and costs associated with testing were of concern. CONCLUSIONS: This study has revealed critical knowledge gaps, preferred communication/support needs, and concerns/risks associated with germline genetic testing in PrCa. Concerns pertaining to family members and insurance discrimination are obvious topics that need to be addressed. Our toolkit may be helpful in addressing knowledge gaps, but further testing is needed to ensure its accessibility across literary and cultural contexts.
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