The Option of Genetic Testing
Table 1. Clinical Utility of Genetic/Genomic Testsa continued...
The impact of the advertising campaign on physicians was also a focus of investigation. Physicians in target cities were more likely to remember hearing an advertisement for testing but did not have increased knowledge compared with physicians in control cities. Physicians in target cities reported increases in patients' questions about genetic testing, genetic counseling referrals, and requests for testing.[30,33] In summary, physicians might have been more likely to make a referral for testing based on the patient's interest in testing, whether or not the doctor is informed enough to consider whether the test is appropriate. The most concerning documented problem with this campaign was that the company targeted the general population, even though genetic testing for BRCA1/2 is only appropriate for a subgroup of women.
In addition to the data from the Myriad campaign, one international study examined the impact of a DTC campaign for genetic testing by a group of researchers in partnership with a popular Polish women's magazine (Twoj Styl). Genetic testing was offered to 5,000 women through an announcement placed in Twoj Styl in October 2001. A total of 5,024 women who qualified received a free genetic test for three BRCA1 mutations that are common in Poland. Genetic counseling was offered only to women with a positive test or with a significant family history of breast or ovarian cancer. The great majority of women who took part in the program expressed a high degree of satisfaction, and after 1 year, approximately two-thirds of identified mutation carriers had complied with breast cancer screening recommendations. No follow-up with women who received a negative test result to assess understanding of their results was conducted nor was subsequent follow-up conducted regarding population screening recommendations.
Research examining DTC testing
DTC genetic testing is advertised directly to consumers, purchased directly by the consumer, and the results are delivered directly to the consumer without the involvement of the consumer's health care provider. Some might suggest that DTC genetic tests promise heightened privacy and the potential that individuals will be more informed and more able to take an active, decision-making role in their medical options.