Men Give Thumbs Up to Video on Genetic Testing in Prostate Cancer

Neil Osterweil

September 20, 2021

What is it about guys and TV? Given a choice between watching a short video about genetic screening for cancer or meeting with a genetic counselor prior to testing, nearly three fourths of the men (71%) in a study opted for the video instead of the face-to-face meeting.

The study involved men who had either received a prostate cancer diagnosis or had a family history of prostate cancer. The information imparted by video or provided by the trained counselor was about germline testing, which can identify patients who have a genetic predisposition to prostate cancer or who may benefit from targeted therapy.

There was no significant difference in how many men decided to undergo testing (94.4% of men who watched the video, and 92% of men who met with a counselor).

However, the video watchers were more likely to be willing to share their test results with others, reported Jessica Russo, MS, and colleagues from the Thomas Jefferson University, in Philadelphia, Pennsylvania.

"Our results support the use of pretest genetic education videos in nongenetic practices to address the shortage of genetic counselors and advance germline testing to capitalize on the progress in precision medicine," they conclude.

The study was published online on September 1 in JCO Precision Oncology.

Germline testing can identify men who are at increased risk for prostate cancer because of BRCA pathogenic variants. It also provides information on hereditary cancer syndromes, such the Lynch syndrome, Russo and colleagues explain.

Pressure to identify men with prostate cancer who are BRCA positive has increased in recent years. Evidence shows that these patients may respond to treatment with PARP inhibitors, and last year the first drug for this indication (rucaparib) was approved by the US Food and Drug Adinistration.

Russo and colleagues note that "with the current increase in men in need of germline testing, there is an increasing need for alternate delivery of pretest informed consent in nongenetic practices as referral of all men to genetic counseling is currently not sustainable."

To see whether video-based patient education could help to narrow the gap, the investigators conducted the Evaluation and Management for Prostate Oncology, Wellness, and Risk (EMPOWER) study. The goal of the study was to streamline delivery of genetic services across a variety of practice types.

The video lasts 11 minutes. It was created by the cancer genetics team at Jefferson University and includes information about cancer heritability, the purpose of testing, risks and benefits, potential results, implications for blood relatives if hereditary syndromes are identified, laws regarding genetic discrimination, and potential reproductive implications.

Participants were tested at baseline for their knowledge of cancer genetics. They were asked to complete surveys about their experience after watching the educational video or attending a counseling session and after they had received genetic results and recommendations by a genetic counselor.

In the article, the team reports interim results on the first 127 participants.

Many men (71%) chose the video rather than genetic counseling (P < .001). There were no differences between the groups in either decisional conflict about germline testing or in satisfaction, as measured by the validated Genetic Counseling Satisfaction Scale.

For both groups, there was similar improvement in knowledge of cancer genetics following the selected intervention, but men who chose the video more frequently reported that they were willing to share their genetic test results with their families (96.4% vs 86.4%; P = .02).

Russo and colleagues note that the sample was largely White (85%) and that 66.9% of the patients had a bachelor's degree or more education. They write that it is "imperative to study digital solutions to pretest genetic delivery across diverse populations to ensure generalizability."

The study was supported by a SKCC TIPS Pilot Funding Grant and a National Cancer Institute Cancer Center support grant. Russo has stock/ownership interests in Agenus. Her co-authors have reported various industry relationships.

JCO Precis Oncol. Published online September 1, 2021. Abstract

Neil Osterweil, an award-winning medical journalist, is a long-standing and frequent contributor to Medscape.

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