Attitudes regarding polygenic risk testing for lung cancer: a mixed-methods study

Background Polygenic risk scores (PRS) hold promise for early lung cancer detection and personalized treatment, yet factors influencing patient interest in PRS-based genetic testing are not well understood. Purpose Grounded in the health belief model, this mixed-methods study explored knowledge, attitudes, perceived benefits and barriers to lung cancer PRS, and preferences for receiving PRS results. Results The study included 141 individuals (41% African American, 63% female) recruited from two hospital affiliates of a comprehensive cancer center in the Southwestern United States. Although participants recognized the severity of lung cancer, knowledge of PRS was limited. Concerns about privacy, psychological impacts, and uncertainty about result usefulness diminished interest in genetic testing for polygenic risk. Significant differences (P < .05) in attitudes were observed: women expressed heightened concerns about psychological effects, and African Americans reported greater perceptions of stigma and concerns about potential familial consequences. Qualitative findings emphasized the psychological burden of learning one's genetic risk, particularly among those with family cancer histories or smoking exposure. Participants emphasized the need for clear, actionable results and assurances of data privacy. Conclusions Perceived benefits and barriers to PRS-based testing varied by sociodemographic and personal risk factors, with concerns about stigma, psychological burden, and privacy shaping attitudes. Given participants' emphasis on clear, actionable results, strategies to enhance uptake should improve risk communication, ensure data privacy, and provide guidance on risk-reducing actions. Tailored approaches addressing subgroup-specific concerns may improve diverse patient engagement and equitable access to PRS.