Background: Community attitudes research regarding genetic issues is important when contemplating the potential value and utilisation of predictive testing for common diseases in mainstream health services. This article aims to report population-based attitudes and discuss their relevance to integrating genetic services in primary health contexts. Methods: Men’s and women’s attitudes were investigated via population-based omnibus telephone survey in Queensland, Australia. Randomly selected adults (n = 1,230) with a mean age of 48.8 years were interviewed regarding perceptions of genetic determinants of health; benefits of genetic testing that predict ‘certain’ versus ‘probable’ future illness; and concern, if any, regarding potential misuse of genetic test information. Results: Most (75%) respondents believed genetic factors significantly influenced health status; 85% regarded genetic testing positively although attitudes varied with age. Risk-based information was less valued than certainty-based information, but women valued risk information significantly more highly than men. Respondents reported ‘concern’ (44%) and ‘no concern’ (47%) regarding potential misuse of genetic information. Conclusions: This study contributes important population-based data as most research has involved selected individuals closely impacted by genetic disorders. While community attitudes were positive regarding genetic testing, genetic literacy is important to establish. The nature of gender differences regarding risk perception merits further study and has policy and service implications. Community concern about potential genetic discrimination must be addressed if health benefits of testing are to be maximised. Larger questions remain in scientific, policy, service delivery, and professional practice domains before predictive testing for common disorders is efficacious in mainstream health care.

Keywords:
Population survey, Primary care, Australia, Gender, Genetic risk, Genetic testing
1.
Khoury MJ, Burke W, Thomson EJ (eds): Genetics and Public Health in the 21st Century: Using Genetic Information to Improve Health and Prevent Disease. New York, Oxford University Press, 2000.
2.
Metcalfe S, Bittles AH, O’Leary P, Emery J: Australia: public health genomics. Public Health Genomics 2009;12:121–128.
3.
Australian Law Reform Commission and Australian Health Ethics Committee (ALRC/AHEC): Essentially yours: the protection of human genetic information in Australia. Sydney, 2003. http://www.alrc.gov.au/publications/report-96.
4.
Chung WK: Implementation of genetics to personalize medicine. Gend Med 2007;4:248–265.
5.
Robins R, Metcalfe S: Integrating genetics as practices of primary care. Soc Sci Med 2004;59:223–233.
6.
Centre for Genetics Education (CGE): DNA genetic testing, screening for genetic conditions and genetic susceptibility. Fact Sheet #21, 2008. http://www.genetics.com.au/factsheet/fs21.asp.
7.
Metcalfe S, Hurworth R, Newstead J, Robins R: Needs assessment study of genetics education for general practitioners in Australia. Genet Med 2002;4:71–77.
8.
Genetic Health Services Victoria: The Genetics File – A GP Resource. 2003. http://www.mcri.edu.au/pages/research/education/genetics-file.asp.
9.
Biotechnology Australia: Genetics in family medicine: the Australian handbook for general practitioners. 2007. http://www.gpgenetics.edu.au.
10.
Davidson ME, Weingarten K, Pollin TI, Wilson MA, Wilker N, Hsu N, Weiss JO: Consumer perspectives on genetic testing: implications for building family-centred public policies. Fam Syst Health 2000;18:217–235.
11.
Emery J, Hayflick S: The challenge of integrating genetic medicine into primary care. Br Med J 2001;322:1027–1030.
12.
Hall WD, Morley KI, Lucke JC: The prediction of disease risk in genomic medicine. EMBO Rep 2004;5(spec No):S22–S26. http://www.nature.com/embor/journal/v5/n1s/full/7400224.html.
13.
Ponce NA, Afable-Munsuz A, Nordyke RJ: Conceptualising the impact of genetic testing on cancer disparities in the USA. Int J Healthc Tech Manag 2007;8:536–548.
14.
Meiser B, Irle J, Lobb E, Barlow-Stewart K: Assessment of the content and process of genetic counseling: a critical review of empirical studies. J Genet Couns 2008;17:434–451.
15.
Hallowell N, Richards MP: Understanding life’s lottery: an evaluation of studies of genetic risk awareness. J Health Psych 1997;2:31–43.
16.
Evers-Kiebooms G, Welkenhuysen M, Claes E, Decruyenaere M, Denayer L: The psychological complexity of predictive testing for late onset neuro-genetic diseases and hereditary cancers: implications for multidisciplinary counselling and for genetic education. Soc Sci Med 2000;51:831–841.
17.
Creighton S, Almqvist EW, MacGregor D, Fernandez B, Hogg H, Beis J, Welch JP, Riddell C, Lokkesmoe R, Khalifa M, MacKenzie J, Sajoo A, Farrell S, Robert F, Shugar A, Summers A, Meschino W, Allingham-Hawkins D, Chiu T, Hunter A, Allanson J, Hare H, Schween J, Collins L, Sanders S, Greenberg C, Cardwell S, Lemire E, MacLeod P, Hayden MR: Predictive, pre-natal and diagnostic genetic testing for Huntington’s disease: the experience in Canada from 1987 to 2000. Clin Genet 2003;63:462–475.
18.
de Snoo FA, Riedijk SR, van Mil AM, Bergman W, ter Huume JA, Timman R, Bertina W, Gruis NA, Vasen HF, van Haeringen A, Breuning MH, Tibben A: Genetic testing in familial melanoma: uptake and implications. Psychooncology 2008;17:790–796.
19.
Craufurd D, Binchy A, Evans G: Uptake and impact of predictive testing – a comparison of breast-ovarian cancer and Huntington’s disease. Abstracts 5th European Meeting on Psychosocial Aspects of Genetics, Rome, September 1996. Gen Couns 1997;8:159.
20.
Leggett BA: Family-based screening for colorectal cancer: the Australian perspective. J Gastroenterol Hepatol 2009;24(suppl 3):29–32.
21.
Christiaans I, Birnie E, Bonsel GJ, Wilde AA, van Langen IM: Uptake of genetic counselling and predictive DNA testing in hypertrophic cardiomyopathy. Eur J Hum Genet 2008;16:1201–1207.
22.
National Health and Medical Research Council: Use and disclosure of genetic information to a patient’s genetic relatives under section 95AA of the Privacy Act 1988 (Cth). Guidelines for health practitioners in the private sector. 2009. http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/e96.pdf.
23.
Hahn S, Letvak S, Powell K, Christianson C, Wallace D, Speer M, Lietz P, Blanton S, Vance J, Pericak-Vance M, Henrich VC; Genomedical Connection: A community’s awareness and perceptions of genomic medicine. Public Health Genomics 2010;13:63–71.
24.
Barlow-Stewart KK, Taylor SD, Treloar SA, Stranger M, Otlowski M: Verification of consumers’ experiences and perceptions of genetic discrimination and its impact on utilisation of genetic testing. Genet Med 2009;11:193–201.
25.
Wilde A, Meiser B, Mitchell PB, Schofield PR: Public interest in predictive genetic testing, including direct-to-consumer testing, for susceptibility to major depression: preliminary findings. Eur J Hum Genet 2010;18:47–51.
26.
Human Genetics Society of Australasia (HGSA): Genetic Testing and Life Insurance in Australia. http://www.hgsa.com.au/images/UserFiles/Attachments/GeneticTestingandInsuranceFINAL080205.pdf (accessed October 2009).
27.
Taylor S, Treloar S, Barlow-Stewart K, Stranger M, Otlowski M: Investigating genetic discrimination in Australia: a large-scale survey of clinical genetics clients. Clin Genet 2008;74:20–30.
28.
Centre for Genetics Education (CGE): Genetic Information and Life Insurance Products in Australia. 2003. http://www.genetics.com.au/pdf/lifeinsurance.pdf (accessed June 2009).
29.
Department of Health and Human Services: The Genetic Information Nondiscrimination Act of 2008: Information for Researchers and Health Care Professionals. http://www.genome.gov/Pages/PolicyEthics/GeneticDiscrimination/GINAInfoDoc.pdf (accessed July 25, 2009).
30.
Swineburne University of Technology: The Swineburne National Technology and Society Monitor. http://www.swinburne.edu.au/lss/acets/monitor/2007MonitorFull.pdf.
31.
Australian Centre for Emerging Technologies & Society (ACETS): Swinburne National Technology and Society Monitor. 2006. http://www.swinburne.edu.au/lss/acets/monitor/2005MonitorFULL.pdf.
32.
Biotechnology Australia: Community Attitudes to Biotechnology. 2007. http://www.biotechnology.gov.au/assets/documents/bainternet/Eurekahealthandmedical200720070801081830.pdf.
33.
Biotechnology Australia: Public Awareness Research. 2005. http://www.biotechnology.gov.au/index.cfm?event=object.showContent&objectID=BAADA361-F11B-165A-5FA7EE664A2BB359.
34.
Biotechnology Australia: Biotechnology Public Attitudes Towards Gene Technology Study. 2003. http://www.biotechnology.gov.au/index.cfm?event=object.show- Content&objectID=F771AD9E-BCD6–81AC-15E8E2C315F1B4DA.
35.
Williams C: Australian attitudes to DNA sample banks and genetic screening. Curr Med Res Opin 2005;21:1773–1775.
36.
Gilding M, Critchley C: Technology and trust: public perceptions of technological change in Australia. Aust J Emerging Technologies and Society 2003;1:52–69.
37.
Barlow-Stewart K, Taylor S, Otlowski M: Knowing your genes: freedom, burden or power?; in Wilson S, Meagher G, Gibson R, Denemark D, Western M (eds): Australian Social Attitudes: The First Report. Sydney, UNSW Press, 2005.
38.
Molster C, Charles T, Samanek A, O’Leary P: Australian study on public knowledge of human genetics and health. Public Health Genomics 2009;12:84–91.
39.
McCormick C: What does the public really think and who do they really trust?; in Stranger M (ed): Human Biotechnology and Public Trust: Trends, Perceptions and Regulation. Hobart, Centre for Law and Genetics, 2007.
40.
Australian Bureau of Statistics: Census of Population and Housing, Socioeconomic Indexes for Areas. Canberra. 2001. http://www.abs.gov.au/ausstats/abs@.nsf/mf/2033.0.55.001/.
41.
Petersen A, Bunton R: The New Genetics and the Public’s Health. London, Routledge, 2002.
42.
Etchegary H, Cappelli M, Potter B, Vloet M, Graham I, Walker M, Wilson B: Attitude and knowledge about genetics and genetic testing. Public Health Genomics 2010;13:80–88.
43.
Stranger M, Chalmers DR, Nicol D: Capital, trust and consultation: databanks and regulation in Australia. Crit Public Health 2005;15:349–358.
44.
Hindmarsh R, Abu-Bakar A: Balancing benefits of human genetic research against civic concerns: essentially yours and beyond – the case of Australia. Pers Med 2007;4:497–505.
45.
Rose AL, Peters N, Shea JA, Armstrong K: Attitudes and misconceptions about predictive genetic testing for cancer risk. Community Genet 2005;8:145–151.
46.
Barnoy S: Genetic testing for late-onset diseases: effect of disease controllability, test predictivity, and gender on the decision to take the test. Genet Test 2007;11:187–192.
47.
Meiser B, Mitchell PB, McGirr H, Van Herten M, Schofield PR: Implications of genetic risk information in families with a high density of bipolar disorder: an exploratory study. Soc Sci Med 2005;60:109–118.
48.
Australian Institute of Health and Welfare (AIHW): Australia’s Health. 2008. http://www.aihw.gov.au/publications/index.cfm/title/10585.
49.
Broom D: Gender and health; in Germov J (ed): Second Opinion: An Introduction to Health Sociology. Melbourne, Oxford University Press, 2005.
50.
Charles N, Walters V: Men are leavers-alone and women are worriers: gender differences in discourses of health. Health Risk Soc 2008;10:117–132.
51.
d’Agincourt-Canning L, Baird P: Genetic testing for hereditary cancers: the impact of gender on interest, uptake and ethical considerations. Crit Rev Oncol Hematol 2006;58:114–123.
52.
Taylor SD: Gender differences in attitudes among those at risk for Huntington’s disease. Genet Test 2005;9:152–157.
53.
Hayden MR: Predictive testing for Huntington’s disease: a universal model? Lancet Neurol 2003;2:141–142.
54.
Evans DG, Maher ER, Macleod R, Davies DR, Craufurd D: Uptake of genetic testing for cancer predisposition. J Med Genet 1997;34:746–748.
55.
Marteau T, Croyle RT: Psychological responses to genetic testing. Br Med J 1998;316:693–696.
56.
Kasparian NA, Butow PN, Meiser B, Mann GJ: High- and average-risk individuals’ beliefs about, and perceptions of, malignant melanoma: an Australian perspective. Psychooncology 2008;17:270–279.
57.
Robb KA, Miles A, Wardle J: Demographic and psychosocial factors associated with perceived risk for colorectal cancer. Cancer Epidemiol Biomarkers Prev 2004;13:366–372.
58.
Montgomery GH, Erblich J, DiLorenzo T, Bovbjerg DH: Family and friends with disease: their impact on perceived risk. Prev Med 2003;37:242–249.
59.
Smith JA, Braunack-Mayer A, Wittert G: What do we know about men’s help-seeking and health service use? Med J Aust 2006;184:16.
60.
Smith JA, Robertson S: Men’s health promotion: a new frontier in Australia and the UK? Health Promot Int 2008;23:283–289.
61.
Richards M: Families, kinship and genetics; in Marteau T, Richards M (eds): The Troubled Helix: Social and Psychological Implications of the New Human Genetics. Cambridge, Cambridge University Press, 1996.
62.
D’Agincourt-Canning L: A gift or a yoke? Women’s and men’s responses to genetic risk information from BRCA1 and BRCA2 testing. Clin Genet 2006;70:462–472.
© 2011 S. Karger AG, Basel
2011
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.