Predictive genetic testing is currently used mainly for untreatable conditions, such as Huntington's disease, or prenatal detection of serious genetic disorders such as cystic fibrosis. Prenatal tests are usually accompanied by an offer of termination of affected pregnancies. Genes have now been isolated that are associated with potentially preventable diseases such as heart disease and cancer and with increased risk from smoking and obesity. This has raised the possibility of providing predictive information to many more people. Such information may eventually reduce disease by facilitating the development of better targeted and more effective treatment.
Informing people of their genetic susceptibility to disease may motivate them to change their behaviour to reduce their risks. However, changing behaviour is often difficult. In this article we review the limited evidence concerning behavioural responses to genetic information on risk. We use this and the literature on behavioural change to consider if and how behaviour might be changed in response to genetic information.
- Changing behaviour is difficult
- Behavioural change is most likely in motivated people who participate in effective interventions
- Providing people with genetic information on risk may not increase their motivation to change behaviour and in some cases may decrease motivation
- Behavioural change may be more likely if people are persuaded that changing their behaviour can reduce the risk of an adverse health outcome and they are given access to evidence based interventions
- Further research is needed to evaluate programmes in which genetic risk information is given, including evaluation of different ways of giving information
- Effective interventions to change behaviour after provision of information on risk need to be developed