Investigating Interest in Cancer Predisposition Testing and Expanded Carrier Screening in Routine Gynecologic Care among Pregnancy Capable Individuals

The goal of this qualitative study was to explore pregnancy capable individuals’ perceptions of having cancer predisposition testing (CPT) and/or expanded carrier screening (ECS) during routine gynecologic care and how these perceptions differ across individuals. A thematic analysis was conducted based on qualitative data from 26 semi-structured interviews with women between 20 and 35 years of age at a single academic health center in the Mountain West of United States. The analysis indicated that participants’ interest in both types of genetic testing were related to (1) illness prevention and preparation, (2) uncertainty management, (3) family members’ health and support, (4) cost, logistics, and privacy, and (5) demographics and current health status. Specific factors related to interest in CPT included experiences with cancer and relevance of cancer prevention and preparation, whereas specific factors impacting women’s interest in ECS were family planning needs, awareness about children’s health, and informed reproductive decision making. The findings add novel evidence to the potential of offering both CPT and ECS during routine, non-obstetrical care in gynecologic clinics. They also have important implications for developing tools to increase individuals’ knowledge about CPT and ECS and to address their needs for informational and structural support as population screening efforts expand.