Awareness, knowledge, and attitudes toward breast cancer polygenic risk scores for precision prevention in a multiethnic cohort of high-risk women.

Abstract

10531 Background: Polygenic risk scores (PRS) have been shown to improve the risk assessment of breast cancer. Though commercially available in the US, PRS testing remains controversial clinically. Recent qualitative research suggests that PRS is understood and accepted by women. However, quantitative research on PRS awareness, knowledge, and attitudes in the US population is scarce. Methods: Between July-September 2024, we surveyed high-risk women without breast cancer enrolled in the Chicago Multiethnic Epidemiologic Breast Cancer Cohort and Cancer Prone Registry. PRS awareness was assessed by asking whether participants had ever read/heard about PRS prior to the survey and discussed PRS with a provider. PRS knowledge was measured using an 11-item “true/false” assessment. The total score ranges from 0-11, with higher scores indicating better knowledge. Participants were also asked to what extent they agreed that PRS testing should be offered to the general population and a routine part of breast cancer risk assessment; and how likely receiving a PRS influences their behaviors toward risk management, using a 4-point Likert scale. We performed linear regression, controlling for demographic and socioeconomic factors. Results: Of 828 women (mean age 56.8 years), 69.5% identified as White, 20.8% as Black, and 9.7% as Other. Overall, 18.5% and 13.2% had ever read/heard about PRS and discussed it with a provider, respectively. Further, 32.9% reported having learned about PRS from a genetic counselor, followed by 23.1% from their own research/reading, 11.2% from a primary care provider, and 6.3% from an oncologist. There were no significant racial/ethnic differences in PRS awareness (Black 13.0%, Other 19.2%, White 20.7%; p = .082) and discussion (Black 11.8%, Other 11.3%, White 14.1%; p = .874). The overall mean score on PRS knowledge was 9.7 (SD 1.4). Black ( β –0.47, se 0.14; p = .001) or Other ( β –0.50, se 0.17; p = .003) women were less likely than White women to score higher on PRS knowledge. Higher education ( p -trend < .001) and income ( p -trend = .002) levels were highly associated with increased knowledge scores. 95.4% and 96.2% agreed or strongly agreed that PRS testing should be offered to the general population and a routine part of breast cancer risk assessment, respectively; 93.9% reported receiving a PRS likely or very likely influences their behaviors toward risk management. Attitudes toward PRS were also high across racial/ethnic and socioeconomic groups. Conclusions: In this diverse cohort of women, PRS awareness and discussion were low, and there were notable gaps in PRS knowledge. Our findings underscore the need to improve patient-provider communication of breast cancer risk and address gaps in PRS knowledge/health literacy when implementing genetic testing including PRS to increase the uptake of risk-stratified, personalized breast cancer screening.