Abstract 1974: Predictors of correct recall of MC1R genetic risk among Hispanic individuals participating in a skin cancer precision prevention trial
Authors: Lacson John C. , Kim Youngchul , Sutton Steven K. , Roetzheim Richard G. , Vadaparampil Susan T. , Soto-Torres Brenda , Kanetsky Peter A. 
Published: April 2023

Abstract
Skin cancer incidence is increasing among US Hispanics, who experience higher morbidity and mortality and are underserved in precision medicine. A large proportion of Hispanics carry risk variants at MC1R, a robust genetic locus for skin cancer susceptibility. Recall is a fundamental psychological mechanism underlying how people receive health recommendations: better recall has been associated with greater adherence and improved outcomes. However, research on recall of genetic testing information for low to moderate penetrance genes, what predicts recall, and the influence of recall on preventive behavior is limited, especially among Hispanics. We report results of secondary analyses from our previously published randomized controlled trial among self-identified Hispanic participants from Tampa, Florida and Ponce, Puerto Rico. Participants randomized to the precision prevention arm (n=282) were provided MC1R risk information (average or higher) and were asked to recall their genetic risk after 3 and 9 months. Predictors of recall (correct recall, did not recall, or misremembered) at each timepoint were determined by backwards stepwise selection that optimizes AIC, which maximizes overall model fit notwithstanding individual variable p-values. Using all trial participants (n=920), intervention effects on 11 primary and secondary preventive behaviors collected at baseline and post-intervention were estimated within strata of 3-month recall. At 9 months post-intervention, there was a borderline difference in risk recall comparing average- and higher-risk participants (p=0.051), with higher-risk participants 3 times less likely to correctly recall their MC1R risk category (vs. misremember, OR=0.31, 95%CI:0.10-0.95) than average-risk participants. Among average-risk participants, common predictors of correct recall across the 3- and 9-month final models were younger age (OR3=0.97, 95%CI:0.94-1.01, OR9=0.96, 95%CI:0.93-0.99) and higher education (OR3=1.64, 95%CI:1.06-2.63, OR9=1.73, 95%CI:1.12-2.81). Among higher-risk participants, higher education was associated with correct recall at both timepoints (OR3=1.30, 95%CI:0.93-1.85, OR9=1.66, 95%CI:1.21-2.32). Reassessment of intervention effects showed no pattern of improved or worsened preventive behavior by 3-month recall among average-risk participants. However, higher-risk participants who correctly recalled at 3 months had greater odds of wearing sunscreen often or always (OR=1.97, p=0.04) and odds of undergoing a professional skin exam (OR=8.89; p=0.001) than those who did not recall or misremembered (OR=1.32, p=0.45, OR=6.36, p=0.007, respectively). Our results suggest the need for additional strategies, such as reinforcement, for Hispanics with lower education to boost recall, which may consequently improve adoption of preventive behaviors.
Citation Format: John C. Lacson, Youngchul Kim, Steven K. Sutton, Richard G. Roetzheim, Susan T. Vadaparampil, Brenda Soto-Torres, Peter A. Kanetsky. Predictors of correct recall of MC1R genetic risk among Hispanic individuals participating in a skin cancer precision prevention trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1974.