Advanced Cancer Patient Knowledge of and Attitudes towards Tumor Molecular Profiling

Grace Davies; Phyllis Butow; Christine E Napier; Nicci Bartley; Ilona Juraskova; Bettina Meiser; Mandy L Ballinger; David M Thomas; Timothy E Schlub; Megan C Best; members of the PiGeOn Project

doi:10.1016/j.tranon.2020.100799

Advanced Cancer Patient Knowledge of and Attitudes towards Tumor Molecular Profiling

Transl Oncol. 2020 Sep;13(9):100799. doi: 10.1016/j.tranon.2020.100799. Epub 2020 May 22.

Authors

Affiliations

¹ The University of Sydney, Faculty of Science, School of Psychology, Psycho-Oncology Co-operative Research Group, Sydney, NSW 2006, Australia. Electronic address: [email protected].
² The University of Sydney, Faculty of Science, School of Psychology, Psycho-Oncology Co-operative Research Group, Sydney, NSW 2006, Australia. Electronic address: [email protected].
³ Cancer Division, Garvan Institute of Medical Research, Sydney, NSW 2010, Australia. Electronic address: [email protected].
⁴ The University of Sydney, Faculty of Science, School of Psychology, Psycho-Oncology Co-operative Research Group, Sydney, NSW 2006, Australia. Electronic address: [email protected].
⁵ The University of Sydney, Faculty of Science, School of Psychology, Psycho-Oncology Co-operative Research Group, Sydney, NSW 2006, Australia. Electronic address: [email protected].
⁶ Psychosocial Research Group, Prince of Wales Clinical School, University of NSW, Sydney, NSW 2032, Australia. Electronic address: [email protected].
⁷ Cancer Division, Garvan Institute of Medical Research, Sydney, NSW 2010, Australia; St Vincent's Clinical School, University of NSW, Sydney, NSW 2010, Australia. Electronic address: [email protected].
⁸ Cancer Division, Garvan Institute of Medical Research, Sydney, NSW 2010, Australia; St Vincent's Clinical School, University of NSW, Sydney, NSW 2010, Australia. Electronic address: [email protected].
⁹ The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Sydney, NSW 2006, Australia. Electronic address: [email protected].
¹⁰ The University of Sydney, Faculty of Science, School of Psychology, Psycho-Oncology Co-operative Research Group, Sydney, NSW 2006, Australia. Electronic address: [email protected].

Abstract

Limited research has indicated that despite their overwhelming interest in tumor molecular profiling (MP),¹ cancer patients have poor knowledge about MP. The current study aimed to investigate demographic and psychological predictors of knowledge and perceived importance of MP in an advanced cancer patient cohort. Eligible participants had advanced solid cancers of any histological type with sufficient accessible tissue for MP and were enrolled in the Molecular Screening and Therapeutics (MoST) Program. A questionnaire was completed by 1074 participants (91% response rate) after consent, prior to undergoing MP. Overall, participants had poor to moderate knowledge of MP, yet perceived MP to have high importance. Higher education, speaking English at home, and greater satisfaction with the decision to undergo MP were associated with higher knowledge scores. More negative attitudes towards uncertainty, greater self-efficacy to cope with results, and lower perceived likelihood of cancer progression were associated with greater perceived importance of MP. Less educated participants and those who do not speak English at home will need clear explanations, visual aids and ample opportunity to ask questions about MP at the time of their decision-making. Clinicians also need to consider psychological factors relevant to patients' decision to pursue MP. Given the increased awareness of and demand for cancer genomic information and the rapidly changing nature of the actionability of MP, these findings will help inform an important ongoing debate on how to facilitate ethical and informed consent and manage patient expectations about personalized treatments.