Clinical Question

Does genetic testing for disease risk motivate patients to change their behavior?

Bottom Line

Patients informed via genetic test results that they were at increased risk of disease did not subsequently alter their behaviors. For example, persons at increased risk of diabetes mellitus or hypertension were no more likely to change their diet or increase their physical activity. Fancy tests do not appear to be motivators for behavior change. (Level of Evidence = 1a−)

Synopsis

These researchers identified 18 studies by searching five databases, including the Cochrane Register, as well as by performing citation searches. The studies were randomized or quasirandomized controlled trials of adults receiving personalized DNA-based risk estimates for which a behavior change might reduce risk. In other words, persons at increased risk of disease—for example, smokers or patients with a family history of melanoma—underwent DNA analysis and were told if they had an increased risk based on a personalized risk estimate. Most of the studies were of low quality (which typically favors treatment) and may have been too small to find small differences. Two authors selected studies for inclusion and abstracted the data. The studies were homogeneous. Overall, communicating specific risk did not change behavior. Telling smokers that they are at increased risk of lung cancer based on their genetic makeup did not induce them to quit smoking. Similarly, patients told they are at risk of melanoma did not use more sunscreen; patients at risk of developing diabetes, obesity, cardiovascular disease, hypertension, or Alzheimer disease did not change their diet or physical activity; and patients at particular risk of alcohol use disorder did not change their drinking habits.

Study design: Meta-analysis (randomized controlled trials)

Funding source: Government

Setting: Various (meta-analysis)

Reference: HollandsGJFrenchDPGriffinSJet alThe impact of communicating genetic risks of disease on risk-reducing health behaviour: systematic review with meta-analysis. BMJ2016;352:i1102.