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      Direct-to-Consumer Genetic Testing Data Privacy: Key Concerns and Recommendations Based on Consumer Perspectives

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          Abstract

          Direct-to-consumer genetic testing (DTC-GT) companies are engaging health consumers in unprecedented ways and leveraging the genetic information they collect to further engage health companies. This has produced controversy about DTC-GT consumer expectations, standards, and perceptions of privacy. In this commentary, we highlight recent events involving DTC-GT companies and controversy about privacy that followed those events and discuss recent studies that have explored DTC-GT consumer concerns about privacy. We discuss DTC-GT company standards of upholding consumer privacy and the general accessibility of DTC-GT company terms of use agreements and privacy policies that are written at reading levels above that of many consumers. We conclude that broader discussions and more research are needed to identify DTC-GT consumer concerns about and expectations of privacy. We anticipate that our recommendations will advance discussions on consumer privacy expectations and protections in an era of increasing engagement in DTC-GT.

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          Most cited references32

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          Estimates of the Heritability of Human Longevity Are Substantially Inflated due to Assortative Mating

          Here, Ruby et al. analyze an unprecedented amount of public family tree data from Ancestry and determine that the heritability of human longevity was well below 10%, lower than the widely-held belief that lifespan...
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            Direct-to-Consumer Genetic Testing: User Motivations, Decision Making, and Perceived Utility of Results.

            To describe the interests, decision making, and responses of consumers of direct-to-consumer personal genomic testing (DTC-PGT) services.
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              Primary care providers’ cancer genetic testing-related knowledge, attitudes, and communication behaviors: A systematic review and research agenda

              Background Primary care providers (PCPs) can play a critical role in helping patients receive the preventive health benefits of cancer genetic risk information. Thus, the objective of this systematic review was to identify studies of US PCPs’ knowledge, attitudes, and communication-related behaviors regarding genetic tests that could inform risk-stratification approaches for breast, colorectal, and prostate cancer screening in order to describe current findings and research gaps. Methods We conducted a systematic search of six electronic databases to identify peer-reviewed empirical articles relating to US PCPs and genetic testing for breast, colorectal, or prostate cancer published in English from 2008 to 2016. We reviewed these data and used narrative synthesis methods to integrate findings into a descriptive summary and identify research needs. Results We identified 27 relevant articles. Most focused on genetic testing for breast cancer (23/27) and colorectal cancer risk (12/27); only one study examined testing for prostate cancer risk. Most articles addressed descriptive research questions (24/27). Many studies (24/27) documented PCPs’ knowledge, often concluding that providers’ knowledge was incomplete. Studies commonly (11/27) examined PCPs’ attitudes. Across studies, PCPs expressed some concerns about ethical, legal, and social implications of testing. Attitudes about the utility of clinical genetic testing, including for targeted cancer screening, were generally favorable; PCPs were more skeptical of direct-to-consumer testing. Relatively fewer studies (9/27) examined PCPs’ communication practices regarding cancer genetic testing. Discussion This review indicates a need for investigators to move beyond descriptive research questions related to PCPs’ knowledge and attitudes about cancer genetic testing. Research is needed to address important gaps regarding the development, testing, and implementation of innovative interventions and educational programs that can improve PCPs’ genetic testing knowledge, assuage concerns about the appropriateness of cancer genetic testing, and promote open and effective patient-provider communication about genetic risk and genetic testing. Electronic supplementary material The online version of this article (doi:10.1007/s11606-016-3943-4) contains supplementary material, which is available to authorized users.
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                Author and article information

                Journal
                J Pers Med
                J Pers Med
                jpm
                Journal of Personalized Medicine
                MDPI
                2075-4426
                09 May 2019
                June 2019
                : 9
                : 2
                : 25
                Affiliations
                Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA 02215, USA; christine_lu@ 123456harvardpilgrim.org
                Author notes
                [* ]Correspondence: rachele_hendricks-sturrup@ 123456harvardpilgrim.org ; Tel.: +1-617-867-4274
                Article
                jpm-09-00025
                10.3390/jpm9020025
                6616921
                31075859
                deb5bd12-956a-45f4-ab07-8062d74990af
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 27 March 2019
                : 06 May 2019
                Categories
                Commentary

                genetic testing,direct-to-consumer,privacy,genetic information,genomic medicine,consumer protections

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