Does undertaking genome sequencing prompt actual and planned lifestyle-related behavior change in cancer patients and survivors? A qualitative study

Abstract Background: In order for genomic testing to fulfil its promise of helping cancer patients and survivors to prevent future disease, it is important to consider its behavioral impact and outcomes. This study explored the factors that participants perceived would impact lifestyle-related behavioral intentions following genome sequencing (GS). Methods: Individual semistructured interviews were conducted to explore behavioral intentions with a purposive subsample of 24 adults with a past or current cancer of likely heritable aetiology who undertook germline GS as part of a larger genetic study (RisC). Participants were interviewed 12 months following their consent to a longitudinal psychosocial sub-study of RisC (PiGeOn study), before receipt of results. Data were analyzed using thematic analysis. Results: Analysis revealed 3 main themes: past prompts, barriers, and motivators to behavior change. The primary goal for behavioral change was to be healthy for oneself and one's family. Past experience of cancer facilitated positive modifications to lifestyle, such as increased exercise and healthy diet, higher prioritization of mental health and well-being, and regular health check-ups and tests. Maintaining these changes, however, was difficult for some due to daily commitments and lack of self-control. Limited knowledge and perceived inevitability of developing cancer due to genetic predisposition were recognized as barriers to making lifestyle changes. Concurrently, future receipt of actionable results was perceived as a powerful driver of behavior change. Conclusion: Understanding barriers and facilitators to behavior intention and patients’ attitudes to recommended lifestyle change in the context of genomic testing can be useful for health care professionals, to guide their discussions of behavioral change.