Abstract C006: Ancestry-specific genetic feedback about lung cancer risk in African American smokers: Cognitive, emotional, and motivational effects
Authors: Bitterman Dina , Htet Khin , Blackman Elizabeth , Lipkus Isaac , Erkmen Cherie , Ragin Camille , Erblich Joel 
Published: January 2023

Abstract
Genetic factors play an important role in the risk of developing lung cancer, a disease that disproportionately affects African American smokers in the U.S. population. Accumulating evidence now suggests that there may be risk factors that are particularly salient among smokers with African genetic ancestry, and that specific ancestry-informative genetic markers can be predictive of lung cancer risk in African American smokers. Although testing for and communication of genetic risk to patients should impact health and screening, results have been mixed. The goal of this study was to evaluate the effects of genetic risk communication that included ancestry-specific risk information among African American smokers. To that end, we conducted a factorial experiment, in which African American smokers (n=166) were randomly assigned to receive hypothetical genetic test results that indicated: 1) high vs. low ancestry-specific genetic risk for lung cancer ("Risk"), and 2) high vs. low African genetic ancestry ("Ancestry"). We hypothesized that participants who are told that they are at high risk for lung cancer based on genes that are prominent in African populations would exhibit increases in cognitive (perceived lung cancer risk), emotional (cancer worry, psychological distress), and motivational (motivation to quit smoking) factors that have been shown in previous research to predict longer-term health behavior change. We further predicted that effects would be particularly salient among participants told that their genetic profile revealed high African ancestry. We assessed outcomes using well-validated Likert-type indices, immediately before and after exposure to the risk information. Results of a 2 (Risk) x 2 (Ancestry) x 2 (Time) mixed effects ANOVA revealed significant and large effects of Risk x Time for all outcomes, such that participants told they have high levels of ancestry-specific risk genes for lung cancer exhibited increases in perceived lung cancer risk, cancer worry, distress and motivation to quit smoking, (p's &lt;0.0001; 0.12 &lt; η2 &lt; 0.24). There was also a significant Ancestry x Time effect on perceived lung cancer risk, but not on the other outcomes, suggesting increased risk perceptions among participants who learned that they have high African genetic heritage. Higher-order interactions of Risk x Ancestry x Time, however, were not significant. Findings highlight the potential utility of providing ancestry-specific genetic feedback to vulnerable and underserved at-risk populations in increasing at key cognitive, emotional, and motivational factors critical to behavior change.
Citation Format: Dina Bitterman, Khin Htet, Elizabeth Blackman, Isaac Lipkus, Cherie Erkmen, Camille Ragin, Joel Erblich. Ancestry-specific genetic feedback about lung cancer risk in African American smokers: Cognitive, emotional, and motivational effects [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C006.