BACKGROUND: Direct access to genomic information has the potential to transform @entity5 risk counseling. We measured the impact of direct-to-consumer genomic risk information on changes to perceived risk (  PR) of breast, prostate, @entity14 among personal genomic testing (PGT) customers. We hypothesized that   PR would reflect directionality of risk estimates, attenuate with time, and be modified by @entity1 characteristics. METHODS: Pathway Genomics and 23andMe customers were surveyed prior to receiving PGT results, and 2 weeks and 6 months post-results. For each @entity5 , PR was measured on a 5-point ordinal scale from "much lower than average" to "much higher than average." PGT results, based on genotyping of common genetic variants, were dichotomized as elevated or average risk. The relationship between risk estimate and   PR was evaluated with linear regression; generalized estimating equations modeled this relationship over time. RESULTS: With the exception of @entity2 (for which   PR was positive regardless of result), elevated risk results were significantly associated with positive   PR, and average risk results with negative   PR (e.g., @entity263 , 2 weeks: least squares-adjusted   PR = 0.77 for elevated risk versus -0.21 for average risk; p-valuedifference < 0.0001) among 1154 @entity1 . Large changes were rare: for each @entity5 , <4 % of @entity1 overall reported a   PR of   3 or more units. Effect modification by age, @entity5 family history, and baseline interest was observed for @entity0 , respectively. A pattern of decreasing impact on   PR over time was consistently observed, but this trend was significant only in the case of @entity14 . CONCLUSIONS: We have quantified the effect on consumer risk perception of returning genetic-based @entity5 risk information directly to consumers without clinician mediation. Provided via PGT, this information has a measurable but modest effect on perceived @entity5 risk, and one that is in some cases modified by consumers' non-genetic risk context. Our observations of modest marginal effect sizes, infrequent extreme changes in perceived risk, and a pattern of diminishing impact with time, suggest that the ability of PGT to effect changes to @entity5 screening and prevention behaviors may be limited by relatively small changes to perceived risk.

The impact of direct-to-consumer personal genomic testing on perceived risk of breast, prostate, XXXX : findings from the PGen study.

@entity1 :: ('9606', 'Species') :: ['participants', 'participant'] @entity263 :: ('MESH:D011471', 'Disease') :: ['prostate cancer'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast, colorectal, and lung cancer'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity2 :: ('MESH:D008175', 'Disease') :: ['lung cancer'] @entity14 :: ('MESH:D015179', 'Disease') :: ['colorectal and lung cancer', 'colorectal cancer']
@entity14 :: (MESH:D015179,Disease) :: ['colorectal, and lung cancer']
