Australian perspectives towards genomics informed risk-based cancer screening programs: a focus group study

BACKGROUND: Predictions of cancer risk based on genomic data (polygenic risk scores) can stratify a population into different risk groups, allowing risk-tailored cancer screening programs. While such approaches are generally viewed as acceptable, there remain gaps in understanding Australian perceptions to guide implementation of future cancer control programs and policies. This project aimed to explore Australians' views on using genomic information to tailor cancer screening and how such programs could be implemented. METHODS: Four focus groups (n = 28) were held using a discussion guide that explored key features at each stage of potential programs: deciding to take the test, completing the test, receiving the results, and the subsequent impact on screening. Reflexive thematic analysis was used to identify, code and report themes. RESULTS: Three central themes emerged: (1) The value of knowing, which reflected motivations to test for personal as well as family and social benefits; (2) Navigating the complexity of genomics, highlighting challenges in understanding potential pre-test information and results; and (3) Trust in testing, providers, and government which influenced program acceptability for the initial genomic testing. However, this trust may not always result in participants following subsequent cancer screening recommendations. CONCLUSION: Our study identifies the need for community education and clear communication about genomics-informed risk-tailored cancer screening. Potential screening programs should consider the role of healthcare professionals and ensure they receive appropriate training to meet public needs. Further research should explore potential adherence to risk-tailored screening recommendations.